Author: Dr Craig Childress

This is important to understand. I’ll try to explain it as simply as I can.

You do not need to prove anything to anyone. You need the mental health people to do their job.

You need professional competence from the mental health people, my people, the doctors. The doctors around you are immensely stupid and lazy, and they don’t care, and no one else seems to care that they’re incompetent either for some reason.

So you’ll need to make them care. You need competent doctors who know what they’re doing. How do we get that?

A: By holding them accountable for their ignorance and knowledge.

That’s where the whole thing turns. Accountability. Let’s unpack that for a moment. There’s another thought to come, but let’s unpack Accountability for a second.

It’s not your fault, what’s happening to you is not your fault, you did nothing wrong.  You’re fine. You’ve got a crazy ex-, the professional technical term for “crazy” is delusional.

That’s the next thought that we’ll come to in a chain of thoughts, but not yet. Let’s stick with the need for competence from the doctors and holding them accountabile for their ignorance and knowledge.

How do we hold the mental health people accountable for the application of knowledge? They are not accurately identifying what the problem is. They made a mistake in identifying the problem. How do we hold them accountable for that?

Begin with language – learn to translate from common-language to technical-language back-and-forth. Make common sense points using the common-language. Make technical points using the technical-language.

We must first diagnose what the pathology is before we know how to treat it.

We must first identify what the problem is before we know how to fix it.

Diagnosis = identify
Pathology = problem
Treatment = fix it

We need to hold them accountable for not accurately identifying the problem – for not accurately diagnosing the pathology. What pathology? What problem?

The crazy ex-spouse – the delusional one, but we’ll get to that in a moment.

We need to hold the ignorant and incompetent mental health people accountable so they will do their job and accurately identify the problem. You don’t need to prove the pathology to them – you need them to do their job.

It is the job of the doctor to accurately identify (diagnose) the problem (pathology). That is their job. You need them to just do their job competently, correctly, accurately. You don’t need to “prove” something, you need them to do their job. Patients should NEVER have to explain a pathology to the doctor – that simply shows you how completely bad things are in the family courts.

Duty to Protect

This is child abuse. This is spousal abuse using the child as the weapon. They have duty to protect obligations.

We just need them to do their job – protect the child.

All mental health professionals have duty to protect obligations. There are three dangerous pathologies, suicide, homicide, abuse (child, spousal, elder). When a mental health professional encounters any dangerous pathology, that triggers their duty to protect obligations to conduct a proper risk assessment for the danger involved (suicide, homicide, abuse), or to ensure that a proper risk assessment is conducted.

They have obligations. How do we hold them accountable to their obligations to accurately identify which parent is the source of the problem? How do we hold them accountable to their obligations to accurately diagnose which parent is the source of the pathology?

A: The APA ethics code. Standard 2.04.

APA Ethics Code

Doctors are not allowed to be ignorant and incompetent.There are two ethical Standards that require them to be competent – Standard 2.01 requires them to know knowledge, Standard 2.04 requires them to apply knowledge.

We need to activate those ethical Standards for competence so we can hold them accountable for their incompetence. Ethical practice is not optional for a psychologist, it’s required. How do we activate Standards 2.01 and 2.04 for competence?

Start with Standard 2.04 Bases or Scientific and Professional Judgments – their application of knowledge. Did they apply the “established scientific and professional knowledge of the discipline” as the bases for their professional judgments?

2.04 Bases for Scientific and Professional Judgments
Psychologists’ work is based upon established scientific and professional knowledge of the discipline.

The moment the pathology is defined within the “established scientific and professional knowledge of the discipline” we have identified the domains of knowledge required – required – to be applied for competent professional practice.

Listen closely, we’re going to twirl an idea in your mind. Once it stops twirling you’ll be properly aligned.

The construct of “parental alienation” does not qualify as the “established scientific and professional knowledge of the discipline”. It will never activate Standard 2.04. We cannot hold them accountable for the construct of “parental alienation”.

Here’s the twirl… we can hold them accountable to real knowledge. If we use real knowledge to define the pathology then… ding… we activate Standard 2.04.

We need to stop arguing about “parental alienation” – simply stop using it and switch to using the “established scientific and professional knowledge of the discipline instead” – ding – Standard 2.04 activates immediately.

When we define the pathology (problem) with your child, your ex-spouse, and your family using the “established scientific and professional knowledge of the discipline”  – THEN – we immediately activate Standard 2.04 and we can hold ALL the mental health people immediately accountable.

So I did that. I defined the pathology entirely from the application of the “established scientific and professional knowledge of the discipline” in Foundations (Childress, 2015).

The moment I did that, Standard 2.04 Bases for Scientific and Professional Judgments became active for them all..

The relevant domains of “established scientific and professional knowledge of the discipline” required for their application are:

•  Attachment – Bowlby and others
•  Family systems therapy – Bowen and others
•  Personality disorders – Millon and others
•  Complex trauma – van der Kolk and others
•  Child development – Tronick and others
•  Self psychology – Kohut and others
•  DSM-5 diagnostic system – American Psychiatric Association

That’s a lot for them to know. Oh well, that’s the necessary knowledge required for application as the bases for their professional judgments – Standard 2.04

But don’t stop there. There’s three stepping-stone ethical Standards – 2.04 to 2.01 – then both lead to Standard 9.01 Bases for Assessments – it’s an ethical trifecta of violations.

Did they apply the knowledge – Standard 2.04 Bases for Scientific and Professional Judgments? Do they even know the necessary knowledge – Standard 2.01 Boundaries of Competence? If they do not know the necessary knowledge, and did not apply the necessary knowledge, did they conduct a proper assessment of the pathology (problem) – Standard 9.01 Bases for Assessment?

I’ve made you dangerous to professional ignorance and incompetence. The professional technical term for making you dangerous to their ignorance is “motivation” – I’ve given you the power to motivate them to care… ding.

One problem solved. Their lack of motivation.

For the closer on the ethical line is Standard 2.03 Maintaining Competence. It’s not my job to teach them, it’s their job to already know.

2.03 Maintaining Competence
Psychologists undertake ongoing efforts to develop and maintain their competence.

Now let’s move to thought two.

Diagnosis Guides Treatment

Identifying what the problem is (diagnosis) guides what we do to the fix the problem (treatment).

Delusional Thought Disorder

The problem is that your ex-spouse is pathological (problematic). They’re crazy (delusional). They see dangers where there are none and they make false allegations (persecutory delusion). They create false beliefs in the child that you are abusively maltreating the child when you’re not.That’s a shared (induced) persecutory delusion.

Greenham & Childress (ResearchGate). Dark Personalities & Delusions 1: Solving the Gordian Knot of Conflict

Attachment Pathology

A child rejecting a parent is a severe attachment pathology. There is no worse attachment pathology than a complete severing of the parent-child attachment bond. That’s as bad as attachment pathology gets.

The attachment system is a primary motivational system of the brain governing all aspects of love-and-bonding throughout the lifespan, including grief and loss. The attachment system is developing its patterns for love-and-bonding during childhood that will be used to guide love and bonding throughout the rest of the lifespan.

Childhood is NOT the time when we want the child to have the worst possible attachment pathology. We need to fix it.

We need a treatment plan. For that we need an accurate diagnosis. The treatment for cancer is different than the treatment for diabetes.

The differential diagnosis for severe attachment pathology is child abuse by one parent or the other. The only cause of severe attachment pathology is child abuse. The only diagnostic question is to identify which parent is abusing the child?

Targeted Parenting Abusive: Is the targeted parent abusing the child, thereby creating the child’s attachment pathology toward that parent?

Allied Parent Abusive: Or is the allied parent psychologically abusing the child by creating a shared persecutory delusion and false (factious; artificially created) attachment pathology for the secondary gain of manipulating the court’s decisions regarding child custody, and to meet the parent’s own emotional and psychological needs?

In all cases of severe attachment pathology surrounding child custody conflict, a proper risk assessment needs to be conducted to the appropriate differential diagnosis for each parent.

We need an accurate diagnosis – NOT a misdiagnosis from the doctors because of their ignorance and incompetence. Returning an accurate diagnosis is their job. They need to do their job. They have duty to protect obligations. They have obligations to inform the court of an accurate diagnosis, not a misdiagnosis because they are ignorant, incompetent, and unethical.

The courts should expect professional competence from the doctors. The courts should receive professional competence from the doctors.

When possible child abuse is a considered diagnosis, our diagnosis need to be accurate 100% of the time. The consequences for the child of misdiagnosing child abuse are too severe.

Accountable

They have obligations. We need to hold them accountable. When we define the pathology from within the “established scientific and professional knowledge of the discipline” we define the domains of knowledge they need to know to comply with Standard 2.04 Bases for Scientific and Professional Judgments.

They are not allowed to be ignorant and incompetent.

Next turn to their vitae to examine where in their background education, training, and experience they developed the competence in 1) delusional thought disorders, 2) attachment pathology, 3) family systems therapy – Standard 2.01 Boundaries of Competence.

If they do not know the necessary knowledge (Standard 2.01) and do not apply the necessary knowledge (Standard 2.04), then their opinions as contained in their recommendations, reports, diagnostic or evaluative statements, including their forensic testimony, are not based on information and techniques sufficient to substantiate their findings – in violation of Standard 9.01 Bases for Assessment.

9.01 Bases for Assessments
(a) Psychologists base the opinions contained in their recommendations, reports, and diagnostic or evaluative statements, including forensic testimony, on information and techniques sufficient to substantiate their findings. (See also Standard 2.04, Bases for Scientific and Professional Judgments.)

Note how Standard 9.01 cites back to Standard 2.04. It’s a trifecta of ethical violations – 2.04 to 2.01, and both to 9.01 – capped by 2.03 if they try to escape by externalizing blame for their ignorance.

If they misdiagnose (misidentify) which parent is abusing the child, they are failing in their duty to protect obligations because of their misdiagnosis. Was their misdiagnosis because of professional negligence?

Google negligence: failure to take proper care in doing something

Cornell Law School negligence definition: Negligence is a failure to behave with the level of care that someone of ordinary prudence would have exercised under the same circumstances.  The behavior usually consists of actions, but can also consist of omissions when there is some duty to act (e.g., a duty to help victims of one’s previous conduct).

Did the mental health professional conduct a proper risk assessment for possible child abuse to the appropriate differential diagnosis for each parent?

All mental health professionals have duty to protect obligations. You don’t need to prove anything to anyone, you just need the doctors to do their job and accurately identify (diagnose) which parent is causing the problem (pathology) in the child and family.

You did nothing wrong. It’s not your fault. Your ex-spouse is crazy. The professional technical term for crazy is “delusional”. The type of delusion is a persecutory delusion, a fixed and false that they are being “malevolently treated in some way.”

From the APA: “Persecutory Type: delusions that the person (or someone to whom the person is close) is being malevolently treated in some way.” (American Psychiatric Association, 2000)

In all cases of severe attachment pathology surrounding child custody conflict, a proper risk assessment needs to be conducted to the appropriate differential diagnosis for each parent.

Targeted Parenting Abusive: Is the targeted parent abusing the child, thereby creating the child’s attachment pathology toward that parent?

Yes or no?

Allied Parent Abusive: Or is the allied parent psychologically abusing the child by creating a shared persecutory delusion and false (factious; artificially created) attachment pathology for the secondary gain of manipulating the court’s decisions regarding child custody, and to meet the parent’s own emotional and psychological needs?

Yes or no?

Diagnosis guides treatment. You want a treatment plan to fix the attachment pathology displayed by the child. For that you will need an – accurate – diagnosis for which parenting is abusing the child.

Craig Childress, Psy.D.
Clinical Psychologist, CA PSY 18857

I spoke with legislative aides to a New York state Senator about the family court issues.

How did I arrange to meet with them? I didn’t. One of their constituents arranged their meeting and invited me to provide information after they did.

I followed-up with this resources email sent to the legislative aides. Information enters the mind-stream. I’m an organizing core, but I’m not the information.

Information travels from mind to mind – there’s a problem – there’s a solution – Judicial Education Curriculum and a Pilot Program for the Family Courts with University Involvement for evaluation research.

A parent set up the meeting and emailed me – “Can you attend?” I said yes. The parent spoke. I spoke. Thirty minutes with this follow-up. Movement by one is movement by all

_____________________________

Attached is an Amicus Letter I wrote regarding CA SB-331, a Kayden’s Law bill, along with a Handout regarding recommendations for a CA Judicial Curriculum & Pilot Program from a section of a Powerpoint presentation I recently gave.

Amicus Letter CA SB-331
https://drcachildress-consulting.com/wp-content/uploads/2023/04/SB-331-Childress-amicus-letter-4-17-23.pdf

Powerpoint Handout: Judicial Curriculum & Pilot Program
https://drcachildress-consulting.com/wp-content/uploads/2023/04/CA-Judicial-Curriculum-Pilot-Program-1.pdf

I am also providing a link and an attachment to the Checklist of Applied Knowledge that I use in my analysis of forensic custody evaluations to document violations to Standard 2.04 Bases for Scientific and Professional Judgments, This violation begins the chain to violations in Standard 2.01 Boundaries of Competence and 9.01 Bases for Assessment.

2.04 Bases for Scientific and Professional Judgments
Psychologists’ work is based upon established scientific and professional knowledge of the discipline.

The established scientific and professional knowledge is:

Attachment – Bowlby & others
Personality disorders – Beck & others
Family systems therapy – Minuchin & others
Complex trauma and child abuse – van der Kolk & others
Child development – Tronick & others
DSM-5 diagnostic system – American Psychiatric Association

Checklist of Applied Knowledge
https://drcachildress-consulting.com/wp-content/uploads/2020/04/Checklist-of-Applied-Knowledge-Extended-4-20-1.pd

I use these documented ethical violations to overturn the incompetent forensic evaluation’s recommendations. That is my current consulting practice in the family courts. My professional practice is built on the unethical practices of forensic psychology.

My Consulting Website describes my current practice in the family courts divided into three sections, one for Attorneys with handouts, one for Mental Health Professionals with resources for them, and one for Parents with information that might be helpful to them.

Dr. Childress Consulting Website
https://drcachildress-consulting.com/

Relevant handouts from the Attorney section include:

Risk Assessment Handout
https://drcachildress-consulting.com/wp-content/uploads/2022/03/1-Handout-Risk-Assessment-3-22.pdf

Dr. Childress Domains of Expertise Handout
https://drcachildress-consulting.com/wp-content/uploads/2023/01/domains-of-specialized-expertise-1-1-23-2.pdf

Pathology Description Handout
https://drcachildress-consulting.com/wp-content/uploads/2022/10/1-Pathology-Description-Handout-10-22-1.pdf

The findings of the New York Blue Ribbon Commission on Forensic Custody Evaluations are absolutely correct:

From Blue Ribbon Commission: “In the New York State courts, judges order and rely on forensic evaluations for some cases involving child custody and parenting time. Statewide, there is no consistent approach regarding if and/or when evaluations are ordered, who may act as a forensic custody evaluator, how evaluators should conduct these evaluations, or how incompetent or unethical evaluations may be subject to review.”

My current court-involved consulting practice IS the review of incompetent and unethical forensic evaluations. I AM the review.

Why am I enforcing ethical standards for competence? Where are the licensing boards? Nowhere to be seen. Why is that? Why aren’t licensing boards protecting consumers from incompetent and unethical practice? Pull the string and it all will begin to unravel. The practice of forensic custody evaluations needs to end. Now. Clinical psychology (treatment not custody) needs to return to court-involved practice.

But clinical psychology will refuse to work in the family courts because it is too professionally dangerous to our licenses. The mental health system in the family courts is a complete mess, and children are being routinely abused as a result – with the participation of the court system.

From Blue Ribbon Commission: “As a result, family courts have extraordinarily high case dockets, long delays in cases being adjudicated, and a dearth of available court-appointed counsel for those financially unable to afford private attorneys.”

We can speed up the court docket considerably. We know what the pathology is, narcissistic-borderline-dark personality pathology. We need to plan for it.

The differential diagnosis for severe attachment pathology is child abuse by one parent or the other. Court processes should be streamlined to automatically seek a proper clinical diagnostic risk assessment for child abuse surrounding all cases of severe attachment pathology displayed by the child (i.e., a child rejecting a parent).

There is only one cause of a child rejecting a parent, child abuse by one parent or the other. The only question is, which parent? The court needs an accurate answer to that central question – which parent is abusing the child? So in all cases of court-involved custody conflict involving severe attachment pathology displayed by the child, a proper risk assessment for possible child abuse needs to be conducted to the appropriate differential diagnosis for each parent.

One parent or the other is abusing the child. The court needs to know – with accuracy – which parent.

The diagnostic assessment protocol needs to be standardized and of the highest quality. This is possible. I recommend that the task of developing structured and standardized diagnostic assessment and treatment protocols for the family courts be given to top universities through a pilot program for the family courts (duration of two years; six-months set-up, one year program, six-months data analysis and reporting).

From Blue Ribbon Commission: “Ultimately, the Commission members agree that some New York judges order forensic evaluations too frequently and often place undue reliance upon them. Judges order forensic evaluations to provide relevant information regarding the “best interest of the child(ren),” and some go far beyond an assessment of whether either party has a mental health condition that has affected their parental behavior. In their analysis, evaluators may rely on principles and methodologies of dubious validity. In some custody cases, because of lack of evidence or the inability of parties to pay for expensive challenges of an evaluation, defective reports can thus escape meaningful scrutiny and are often accepted by the court, with potentially disastrous consequences for the parents and children.”

My court-involved consulting practice IS the challenge of an evaluation, I am the scrutiny for defective reports – Dr. Childress Consulting Website. My services are essentially a surcharge on the forensic custody evaluation to correct the deficiencies of the forensic custody evaluator.

From Blue Ribbon Commission: “As it currently exists, the process is fraught with bias, inequity, and a statewide lack of standards, and allows for discrimination and violations of due process.”

This is correct. The process also allows and often participates in the psychological abuse of the child by a narcissistic-borderline-dark personality parent, and the spousal emotional and psychological abuse of the ex-spouse and parent using the child as the weapon. The family courts are active child abuse and active spousal abuse, and no one is stopping either.

From Blue Ribbon Commission: “By an 11-9 margin, a majority of Commission members favor elimination of forensic custody evaluations entirely, arguing that these reports are biased and harmful to children and lack scientific or legal value. At worst, evaluations can be dangerous…”

I fully concur with the majority opinion of the New York Blue Ribbon Commission on Forensic Custody Evaluations. Forensic custody evaluations need to end, and clinical psychology (treatment not custody) needs to return to court-involved practice.

I have a webpage in the Attorney section in which I compile my blog posts regarding the serious problems with forensic custody reports – immensely serious problems. They violate multiple ethical standards and they are not valid. The forensic psychologists know, they just don’t care.

Dr. Childress on Forensic Custody Evaluations
https://drcachildress-consulting.com/custom-page/6-child-custody-evaluations

NY Senate Bill 5385 ending the practice of forensic custody evaluations has my full support and is immensely needed. At the same time, clinical psychology (treatment not custody) needs to return to the family courts or else these families and children will have no mental health involvement and the pathology is child abuse and spousal abuse by a narcissistic-borderline-dark personality parent.

Greenham & Chidress (in submission): Dark Personalities & Delusions Part I: Solving the Gordian Knot of Conflict
https://www.researchgate.net/publication/369741224_Dark_Personalities_and_Induced_Delusional_Disorder_Part_I_Solving_the_Gordian_Knot_of_Conflict_in_the_Family_and_Domestic_Violence_Courts

Greenham & Chidress (in submission) Dark Personalities & Delusions Part II: Research Gap in the Family Courts
https://www.researchgate.net/publication/363197057_Dark_Personalities_and_Induced_Delusional_Disorder_Part_II_The_Research_Gap_Underlying_a_Crisis_in_the_Family_and_Domestic_Violence_Courts

Greenham, Childress, & Pruter (in submission): Dark Personalities & Delusions Part III: Identifying Pathogenic Parenting
https://www.researchgate.net/publication/368330924_Dark_Personalities_and_Induced_Delusional_Disorder_Part_III_Identifying_the_Pathogenic_Parenting_Underlying_a_Crisis_in_the_Family_and_Domestic_Violence_Courts

These families have no competent mental health care for an extremely serious pathology. Who can they turn to? Me. I ‘m the only one. I am a clinical psychologist. I’ve returned to the family courts because these children need competent mental health services – this is child abuse pathology. I am a trauma psychologist out of foster care, this is my pathology.

I could use some help. Where are the licensing boards enforcing ethical standards of practice?

We need standardized and top-quality diagnostic assessment and treatment protocols, these can be developed through top-tier university involvement on a pilot program for the family courts to do just that – develop the diagnostic assessment and treatment protocols for the pathology in the family courts.

Crag Childress, Psy.D.
Clinical Psychologist, CA PSY 18857

Kayden’s Law is unbalanced. There is also Eryk.

Kayden’s Law is a national law seeking to protect children from abusive parents following divorce. It links concerns for child abuse and concerns surrounding prior allegations of “domestic violence”.

Kayden’s Law is written with the influence of one litigant’s side in the court-involved custody conflict, the allied parent. As a result, it is unbalanced and does not address or consider the concerns of the other litigant in the child custody conflict, the targeted parent.

There are two litigants in court-involved child custody conflict, and each litigant is making allegations of child abuse toward the other.

1.)  The allied parent is alleging that the targeted parent is abusing the child in some way, resulting in the child’s attachment pathology toward that parent.

A 2-person attribution of causality.

2.)  The targeted parent is alleging that the allied parent is psychologically abusing the child and creating a shared persecutory delusion and false (factitious) attachment pathology for secondary gain of manipulating the court’s decisions regarding child custody.

A 3-person triangle attribution of causality.

Each litigant’s concerns need a fair and balanced examination by the court. Kayden’s Law is unbalanced because it only addresses the concern of the allied parent litigant, and does not address the concerns of Eryk – of the targeted-protective parent. Eryk represents the concerns of the targeted parent.

Both sides in court-involved custody conflict are alleging that the other parent is abusively maltreating the child. The arguments and positions of both sides need fair and balanced consideration by the court.

The clinical concern is that the targeted parent is being emotionally and psychologically abused by a narcissistic-dark personality parent using the child as the weapon (DSM-5 V995.82 Spouse or Partner Abuse, Psychological). The concern of the targeted parent is that the allied parent is psychologically abusing the child by creating a shared persecutory delusion and false (factitious) pathology in the child for the secondary gain of manipulating the court regarding its child custody decisions.

These are the concerns of Eryk.

The concerns raised for Kayden are valid. So are the concerns raised for Eryk. There are two sides in the litigation – both sides have their legitimate concerns. Only one side is addressed by Kayden’s Law. It needs to be adjusted to also include concerns for Eryk.

There are cats.  There are dogs. The existence of cats does not nullify the existence of dogs. Both dogs and cats have fur, four legs, and a tail, but there are ways to tell them apart when we know what to look for. Both exist.

In all cases of court-involved child custody conflict involving attachment pathology displayed by the child, a proper risk assessment for possible child abuse needs to be conducted to the appropriate differential diagnosis for each parent.

Differential Diagnosis:

• • • Targeted Parent Abusive: Is the targeted parent abusing the child in some way, thereby creating the child’s attachment pathology toward that parent?

• • • Allied Parent Abusive: Or is the allied parent psychologically abusing the child by creating a shared persecutory delusion and false (factitious) attachment pathology in the child for secondary gain to the pathological narcissistic-borderline-dark personality parent of manipulating the court’s decisions regarding child custody, and to meet the pathological parent’s own emotional and psychological needs?

When possible child abuse is a considered diagnosis, our diagnosis must be accurate 100% of the time. The consequences of misdiagnosing child abuse are too devastating for the child, too devastating for Kayden and Eryk.

The assessment for a delusional thought disorder is a Mental Status Exam of thought and percption – and the severity of delusional thought disorders can be rated on a 1-to-7 scale using Item 11 Unusual Thought Content of the Brief Psychiatric Rating Scale – “one of the oldest, most widely used scales to measure psychotic symptoms” (Wikipedia; BPRS)

• • • Mental Status Exam (Martin, 1990) – National Institute of Health

https://www.ncbi.nlm.nih.gov/books/NBK546682/

• • • Brief Psychiatric Rating Scale

https://www.researchgate.net/publication/284654397_Brief_Psychiatric_Rating_Scale_Expanded_version_40_Scales_anchor_points_and_administration_manual

There are dogs. There are cats. There is Kayden’s story. There is Eryk’s story. When child abuse is a considered diagnosis, our diagnosis must be accurate 100% of the time. The consequences of our misdiagnosing child abuse are too severe – and the price of our failure to return an accurate diagnosis in either direction is paid by the child.

In all cases of child abuse concerns expressed by either parent in court-involved custody litigation, a proper risk assessment for possible child abuse needs to be conducted to the appropriate differential diagnosis for each parent.

Differential Diagnosis

In court-involved child custody conflict involving severe attachment pathology displayed by the child, the differential diagnosis requiring a proper risk assessment is:

1. Targeted Parent Abusive: Is the targeted parent abusing the child, thereby creating the child’s attachment pathology toward that parent?

2. Allied Parent Abusive: Is the allied parent psychologically abusing the child by creating a shared persecutory delusion and false (factitious) attachment pathology in the child for secondary gain to the pathological narcissistic-borderline-dark personality parent of manipulating the court’s decisions regarding child custody, and to meet the pathological parent’s own emotional and psychological needs?

The diagnoses of concern relative to the allied parent are:

1.) Child Psychological Abuse (DSM-5 V995.51) by the allied parent (i.e., a shared persecutory delusion and factitious attachment pathology created for secondary gain),

2.) Spouse or Partner Abuse, Psychological (DSM-5 V995.82) of the targeted parent by the allied narcissistic-borderline-dark personality parent using the child as the weapon of spousal emotional and spousal abuse.

In legislation providing guidance to court decisions on child custody, the legitimate concerns of both litigants need a fair and balanced examination. Kayden’s Law is unbalanced and the legislation requires greater balancing influence from Eryk’s concerns.

There are three sections to Kayden’s Law:

1) Restrictions on Treatment Interventions – with no designation of the diagnosis being treated.

2) Restrictions on Expert Qualifications – that are unbalanced and inadequate.

3) Judicial Education Curriculum – that is unbalanced in one litigant’s favor.

SB-331 was written with the influence of one litigant’s concerns in court-involved custody conflict. SB-311 requires the balancing influence of the other litigant’s position, the position of the targeted parent. Is there a shared persecutory delusion created by a pathologically narcissistic–borderline-dark personality parent?

From Walters & Friedlander: “In some RRD families [resist-refuse dynamic], a parent’s underlying encapsulated delusion about the other parent is at the root of the intractability (cf. Johnston & Campbell, 1988, p. 53ff; Childress, 2013). An encapsulated delusion is a fixed, circumscribed belief that persists over time and is not altered by evidence of the inaccuracy of the belief.”

From Walters & Friedlander: “When alienation is the predominant factor in the RRD [resist-refuse dynamic}, the theme of the favored parent’s fixed delusion often is that the rejected parent is sexually, physically, and/or emotionally abusing the child. The child may come to share the parent’s encapsulated delusion and to regard the beliefs as his/her own (cf. Childress, 2013).” (Walters & Friedlander, 2016, p. 426)

Walters, M. G., & Friedlander, S. (2016). When a child rejects a parent: Working with the intractable resist/refuse dynamic. Family Court Review, 54(3), 424–445.

Professional concerns for balance will be discussed for each section.

Section 1: Restrictions on Interventions

From SB-331: “This bill, Piqui’s Law, the Safe Child Act, would prohibit court-ordered family reunification services as part of a child custody or visitation rights proceeding, including reunification or reconnection therapy, treatments, programs, workshops, classes, or camps that are predicated on cutting off a child from a parent with whom the child is bonded or to whom the child is attached.”

Legislation should not be mandating or restricting treatment. The treatment decisions made by doctors are based on diagnosis. If the diagnosis is Child Psychological Abuse (DSM-5 V995.51) by the allied narcissistic-borderline-dark personality parent, then a protective separation of the child from the abusive parent is warranted and a necessary child protection response is required.

It is unwise for legislation to limit the discretion of the court in making child protection decisions based on the situation and arguments made to the court.

Diagnosis guides treatment. The treatment for cancer is different than the treatment for diabetes. What is the diagnosis not being treated by the treatment restrictions of SB-331?

Is it V995.51 Child Psychological Abuse by the allied parent? Is SB-331 mandating no treatment be provided to the child who is being abused by a narcissistic-borderline-dark personality allied parent?

Greenham, M.B. and Childress, C.A. (2023). Dark personalities and induced delusional disorders, Part 1: Solving the Gordian knot of conflict in the family and domestic violence courts. ResearchGate doi: 10.13140/RG.2.2.28643.22568

Legislation restricting treatment should be cautiously undertaken and based on diagnostic clarity. The restrictions on treatment-related interventions proposed by SB-331 represent the concerns of one party in the litigation but are not balanced by the concerns of the other litigant.

Attachment Bonding

Of substantial concern is the imprecise definition of diagnostic criteria contained within SB-331 regarding the construct of “with whom the child is bonded or to whom the child is attached.” Does this refer to a Secure attachment bond to the allied parent, or would an Insecure attachment bond also be considered “bonded” and “attached”?

If BOTH a Secure and Insecure attachment to the allied parent are considered as meeting the criteria of SB-331, then all types of pathological parenting are protected from intervention and, under SB-331, the court will never be able to order a protective separation of the child from a pathological parent or order appropriate treatment.

If, on the other hand, only a Secure attachment to the allied parent meets the criteria of SB-331, then in all cases of child custody litigation involving attachment pathology displayed toward the targeted parent, the attachment category (Secure or Insecure) with the allied parent will need to be identified before treatment for the attachment pathology with the targeted parent can be initiated.

That is inappropriately burdensome. The issue with the child’s displayed attachment pathology toward the targeted parent should not require identification of the child’s Insecure attachment bond to the allied parent – the issue is child abuse.

Establishing a criteria for court decision-making of first identifying the attachment category of the allied parent is a misdirected focus of diagnosis asking proof of pathogenic parenting where none is needed. The attachment pathology displayed by the child is NOT directed toward the allied parent, it is directed toward the targeted parent, and the diagnostic focus needs to remain on that parent-child attachment bond.

1.) Is the targeted-rejected parent authentically abusing the child, thereby creating the child’s attachment pathology toward that parent?

2.) Or is the allied parent psychologically abusing the child by creating a shared persecutory delusion and false (factitious) pathology in the child for the secondary gain of manipulating the court’s decisions regarding child custody?

Family Systems Pathology

The family systems description for the pathology of concern is the child’s “triangulation” into the spousal conflict by the allied parent who has created a “cross-generational coalition” with the child against the targeted parent, resulting in an “emotional cutoff” in the child’s attachment bond to the targeted parent.

This family systems dynamic of concern is depicted in a structural family diagram from Salvador Minuchin:

Healthcare decisions about treatment should be based on diagnosis. Restricting treatment options available to the healthcare professionals and court based on the concerns of only one litigant is inappropriate. Balancing information needs to be incorporated into SB-331.

Corrective Focus

My recommendation for improving the goal of section 1 would be to first specify the scope of allowed parenting.

• • • In the absence of child abuse, parents have the right to parent according to their cultural values, their personal values, and their religious values.

• • • In the absence of child abuse, each parent should have as much time and involvement with the child as possible.

• • • In the absence of child abuse, to restrict either parent’s time and involvement with their child would damage the child’s attachment bond to that parent, thereby harming the child and harming that parent.

The concern in court-involved custody conflict are the allegations of child abuse made by each parent toward the other. Legislation to protect children from child abuse should specify that in all cases of court-involved child custody conflict involving severe attachment pathology displayed by a child, a proper risk assessment for possible child abuse needs to be conducted to the appropriate differential diagnosis for each parent.

Section 2: Restrictions on Experts

From SB-331: “The bill would provide that a person is qualified to testify as an expert in a child custody proceeding in which a parent has been alleged to have committed domestic violence or child abuse, as specified, if the person shows by any otherwise admissible evidence that the person has sufficient special knowledge, skill, experience, training, or education relating to the subject of the person’s testimony.”

Professional competence in forensic psychology is extremely low, and professional standards of practice need to be established. I recommend application of Standards 2.01 Boundaries of Competence and 2.04 Bases for Scientific and Professional Judgments of the APA ethics code as the bases for establishing professional competence (“expertise”) in court-involved professional psychology.

The relevant domains of established scientific and professional knowledge of the discipline required for application are:

• • • Attachment – Bowlby and others
    • Family systems therapy – Bowen and others
    • Personality disorders – Millon and others
    • Complex trauma – van der Kolk and others
    • Child development – Tronick and others
    • Self psychology – Kohut and others
    • DSM-5 diagnostic system – American Psychiatric Association

If the ethical standards of the American Psychological Association were applied in the family courts, issues of professional “expertise” would vanish into professional competence. All doctors should apply exactly the same information (the best) to reach exactly the same conclusions (accurate), and exactly the same recommendations to the court (effective at resolving the child’s attachment pathology).

The restrictions on expert status are unnecessary if basic ethical Standards are enforced by state licensing boards.

“Parental Alienation” Construct

There is no such thing as “parental alienation” in clinical psychology and the use of that construct in a professional capacity is substantially beneath professional standards of practice, and is in violation of Standard 2.04 Bases for Scientific and Professional Judgments of the APA ethics code.

The Gardnerian PAS “experts” represent a fringe group of professionals who reject the diagnostic guidance of the American Psychiatric Association and the ethical guidance of the American Psychological Association.

The construct of “parental alienation” needs to be discontinued in professional use – and ONLY the “established scientific and professional knowledge of the discipline” should be applied as the bases for professional judgments.

2.04 Bases for Scientific and Professional Judgments
Psychologists’ work is based upon established scientific and professional knowledge of the discipline.

The relevant domains of established scientific and professional knowledge of the discipline required for application are:

• • • Attachment – Bowlby and others
    • Family systems therapy – Bowen and others
    • Personality disorders – Millon and others
    • Complex trauma – van der Kolk and others
    • Child development – Tronick and others
    • Self psychology – Kohut and others
    • DSM-5 diagnostic system – American Psychiatric Association

Absence of Licensing Board Oversight

Concerns for “expert” status in the family courts could be (already should be) addressed by enforcing compliance with ethical standards of practice (Standards 2.01 and 2.04 of the APA ethics code). The question for consideration by state legislators is why the state licensing board is not enforcing ethical standards of practice in court-involved professional psychology?

Section 3: Judicial Education Curriculum

From SB-311: “This bill would require a judge assigned to family law matters involving child custody proceedings and individual courts to submit the number of hours of continuing instruction in domestic violence completed to the Judicial Council.”

From SB-311: “Existing law requires the Judicial Council to establish judicial training programs for individuals who perform duties in domestic violence matters. Existing law requires the training programs to include a domestic violence session in any orientation session for newly appointed or elected judges and an annual training session in domestic violence. Existing law requires the training programs to include instruction in all aspects of domestic violence, including, but not limited to, the detriment to children of residing with a person who perpetrates domestic violence.”

From SB-311: “This bill would repeal those provisions and instead require the Judicial Council to establish mandatory judicial training programs for individuals, including judges and judges pro tem, who perform duties in family law matters, including, among other topics, child sexual abuse and coercive control, as specified.”

This is the section of SB-331 that is of highest concern. The proposed Judicial Education Curriculum is both inadequate and highly unbalanced in favor of one litigant’s position (the allied parent) and ignores the other litigant’s concerns (the targeted parent).

Whoever decides on the Judicial Education Curriculum will have the power to systematically influence judicial decisions in child custody conflicts in favor of one parent’s position. It is imperative that the Judicial Education Curriculum be balanced for the concerns of BOTH litigants in the custody conflict.

Recommendations for adjusting the Judicial Education Curriculum are posted to my website:

Click to access CA-Judicial-Curriculum-Pilot-Program.pdf

In addition to minor balancing wording adjustments to the proposed Judicial Education Curriculum, three additional domains of judicial curriculum are needed:

1.) Educational curriculum in narcissistic, borderline, and dark personality pathology.

2.) Educational curriculum on family systems constructs.

3) Educational curriculum on attachment pathology and its treatment

Pilot Program for the Family Courts

The fighting surrounding the child needs to end. We need to develop standardized diagnostic assessment and treatment protocols that all mental health professionals agree with and apply.

This goal can be effectively accomplished through a pilot program for the family courts with university involvement to develop the necessary diagnostic assessment and treatment protocols.

There is a problem in the family courts. The solution is to turn the problem over to our universities and task them with developing the standardized diagnostic assessment and treatment protocols needed for the family courts – and the supporting legal arguments for a treatment-oriented approach at resolution.

California has world-class universities. For California, I recommend that the Principle Investigator for the pilot program be located in Stanford Forensic Psychiatry, with a second satellite site in Southern California of a UCLA, Pepperdine, and Alliant university collaboration.

I recommend that Stanford-UCLA be tasked with developing the diagnostic assessment protocol, and that the Southern California location of UCLA-Pepperdine-Alliant be tasked with developing the treatment protocol.

I recommend that treatment protocol development includes teams from Dialectic Behavior Therapy (Linehan; Univeristy of Washington), Emotionally Focused Therapy (Johnson – Tronick; International Center for Excellence in EFT), and Internal Family Systems Therapy (Schwartz; IFS Institute).

I recommend that teams from the law schools of Stanford, UCLA, and Pepperdine develop the supporting legal arguments for a treatment-oriented resolution of the custody conflict in the courts.

I have posted an Amicus Letter regarding SB-331 to my website:

Click to access SB-331-Childress-amicus-letter-4-17-23.pdf

Craig Childress, Psy.D.
Clinical Psychologist, CA PSY 18857

 

This is my sixth post of my line-by-line notes for the AFCC & NCJFCJ Joint Statement on Parent-Child Contact Problems.

Notes 6 is in response to the content of the first recommendation from the AFCC and JCJFCJ for a “Child Centered Approach”.

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Line-by-Line Notes 6

From the AFCC & NCJFCJ:

1.  Adopt a child-centered approach

Children’s behavior should be considered in the context of what is normal for a child’s age, developmental stage, and the family socio-cultural-religious norms. This behavior may also be an expectable, adaptive reaction to stress, change, or an adverse childhood experience. The paramount focus of practitioners working with parent-child contact problems should be to promote the safety, interests, rights, and wellbeing of children and their parents/caregivers at all socioeconomic levels. Children should have the opportunity to express their views in family justice matters that concern them. The stated views of children are not necessarily determinative of their best interests.There are multiple factors that may contribute to children expressing views that do not reflect their best interests. Family justice practitioners should understand the basis for the contact child’s expressed wishes and acknowledge their rights.

Dr Childress Notes 6:

Sentence 1:

From the AFCC & NCJFCJ: “Children’s behavior should be considered in the context of what is normal for a child’s age, developmental stage, and the family socio-cultural-religious norms.”

Child Development Knowledge:

That is a broad set of child development knowledge set forth as required in application. I agree. There is no excuse for professional ignorance. I have that knowledge from a lifetime in child and family therapy, including early childhood and the neuro-development of the brain. Based on my 10 years of experience in the family courts, I seriously doubt that any forensic psychologist has the required competence based on their education, training, and experience in child development across childhood.

The required domains for professional competence required for application in the family courts are:

• • • Attachment – Bowlby and others
    • Family systems – Minuchin and others
    • Personality pathology – Beck and others
    • Complex trauma – van der Kolk and others
    • Child development – Tronick and others
    • Self psychology – Kohut and others
    • DSM-5 delusional thought disorders and FDIA.

While I have this knowledge, I am fairly confident that no forensic psychologist possesses this knowledge because none of this knowledge is seen in application.

Start with Tronick in the domain of child development, and the “breach-and-repair” sequence. The worst thing we can possibly do is leave a breached attachment bond un-repaired. Child development knowledge requires an understanding for the attachment system in childhood, the importance and impact of the breach-and-repair sequence, and the role of intersubjectivity in the child’s emotional and psychological development. This child development knowledge should also include Kohut and parental self-object functions (Mirroring, Idealization, Twinship), and the role of optimal frustration for transmuting internalizations of self-object functions served by the parent into the child’s own self-structure.

I doubt the authors of this Joint Statement mean to suggest that child development knowledge (Tronick, Bowlby, Kohut) is actually a requirement since the domain of knowledge necessary is so extensive, and I suspect they meant something more superficial – but knowledge of child development needs to be required for application. There is no excuse for ignorance, the issues are too important for the child.

When possible child abuse is a considered diagnosis, our diagnosis must be accurate 100% of the time. The differential diagnosis for court-involved attachment pathology displayed by the child is possible child abuse, either 1) by the targeted-rejected parent creating the child’s attachment pathology toward this parent (a two-person attribution of causality), or 2) psychological child abuse by the allied parent creating a shared persecutory delusion in the child (a three-person triangle attribution of causality) – i.e., a false attachment pathology imposed on the child by a narcissistic-borderline-dark personality parent for the secondary gain of manipulating the court’s decisions regarding child custody (DSM-5 FDIA 300.19).

If a wrong decision is made surrounding child abuse, the court could potentially become a participant in the child abuse. To the extent that the court relies on the guidance of professional of psychology regarding the possible child abuse involved in the family, the court needs to receive accurate information.

When child abuse is a considered diagnosis, as is it in court-involved child custody conflict, the diagnosis returned from professional psychology that will guide the court’s decisions must be accurate 100% of the time.

There is no excuse for professional ignorance with such importance to the outcome of the diagnoses. Child development knowledge for all phases of childhood (Tronick, Bowlby, Kohut) is essential professional knowledge.

Cultural Considerations

Cultural considerations are prominent in all families. There are always two cultures involved, one from each parent, even in one-ethnicity families (like two White parents), there are still family cultural factors from each parent’s family of origin history. Each parent provides a family heritage, a family lineage, and a family culture to the child that is the birthright of the child. The child unites two cultures, two family lineages, two family heritages into their very self-identity. For a child to reject either parent is for the child to reject half of themselves. We need to fix the attachment pathology in the family.

We need to repair breached attachment bonds in childhood. We never leave a breached attachment bond un-repaired. That is the worst possible thing we can  do.

If there is child abuse by the targeted-rejected parent, diagnose it and protect the child. Then place it on a treatment plan and fix it. Then repair the child’s normal-range and healthy attachment bond to this parent. We always repair a breached attachment bond. The worst thing we could possibly do is leave a beached attachment bond un-repaired (Tronick: “the ugly”).

In the absence of child abuse, parents have the right to parent according to their cultural values, their personal values, and their religious values. The only relevant issue is whether there is child abuse.

In all cases of court-involved custody conflict surrounding child attachment pathology, a proper risk assessment for possible child abuse needs to be conducted to the differential diagnosis of:

• • • Possible child abuse by the targeted parent creating the child’s attachment pathology toward that parent (a two-person attribution of causality),

• • • Possible Child Psychological Abuse (DSM-5 V995.51) by the allied narcissistic-borderline-dark personality parent creating a shared persecutory delusion in the child (a three-person triangle attribution of causality).

The recommendation contained in this first sentence requires a substantial knowledge of child development. In the absence of child abuse, parents have the right to parent according to their cultural values, their personal values, and their religious values.

Sentence 2:

From the AFCC & NCJFCJ: “This behavior may also be an expectable, adaptive reaction to stress, change, or an adverse childhood experience.”

Kohut, optimal frustration.

In the absence of child abuse, parents have the right to parent according to their cultural values, their personal values, and their religious values. In the absence of child abuse, to restrict either parent’s time and involvement with their child would damage the child’s attachment bond to that parent, thereby harming the child and harming that parent.

Sentence 3:

From the AFCC & NCJFCJ: “The paramount focus of practitioners working with parent-child contact problems should be to promote the safety, interests, rights, and wellbeing of children and their parents/caregivers at all socioeconomic levels.”

Safety

Safety is the lead issue in the list of paramount importance. Safety of children surrounding nearly all divorced families is seldom an issue. The “safety” of children is a child abuse risk, i.e, an abusive parent. All child abuse concerns should receive a proper risk assessment.

When possible child abuse is a considered diagnosis (i.e., “safety”), a proper risk assessment should always be conducted.

The differential diagnoses with court-involved custody conflict are:

1. 1. 1. Targeted Parent: possible child abuse by the targeted parent resulting in the child’s attachment pathology to that parent (a two-person attribution of causality).

If the targeted parent is abusive of the child, diagnose the child abuse and protect the child. Place the abusive parenting on a treatment plan and fix it, then restore the child’s healthy attachment bond to their parent.

1. 1. 2. Allied Parent: possible Child Psychological Abuse (DSM-5 V995.51) by the allied parent who has created a shared persecutory delusion and false attachment pathology in the child for the secondary gain of nullifying the court’s orders for child custody and manipulating the court’s custody decisions (a three-person triangle attribution of causality).

If the allied parent is psychologically abusing the child, diagnose the child abuse and protect the child. Recover the child’s healthy and normal-range development. Once the child’s recovery is stabilized, restore contact with the abusive parent with enough safeguards in place to ensure that the abuse does not resume when contact with the abusive parent is restored.

All mental health professionals have duty to protect obligations. When possible child abuse (“safety”) is a considered diagnosis, as it is surrounding court-involved child custody conflict, a proper risk assessment should be always conducted. Failure to conduct a proper risk assessment for possible child abuse when possible child abuse is a considered diagnosis would represent a negligent failure in the mental health professional’s duty to protect obligations.

Cornell Law School Negligence Definition: “A failure to behave with the level of care that someone of ordinary prudence would have exercised under the same circumstances.  The behavior usually consists of actions, but can also consist of omissions when there is some duty to act (e.g., a duty to help victims of one’s previous conduct).

https://www.law.cornell.edu/wex/negligence

When child “safety” concerns are a consideration (as is indicated by the “paramount focus” recommendation from the AFCC and NCJFCJ), a proper risk assessment for possible child abuse needs to be conducted.

The potential diagnostic concern is 1) possible child abuse by the targeted parent, or 2) possible psychological child abuse by the allied narcissistic-borderline-dark personality parent who is creating a Factitious Disorder Imposed in Another (DSM-5 300.19), i.e., a false attachment pathology and shared persecutory delusion in the child, for the secondary gain of manipulating the court’s decisions on child custody through the induced child pathology.

Socioeconomic Levels

From AFCC & NCJFCJ: “…socioeconomic levels”

Equal access and equal quality of mental health services is guaranteed by Principle D Justice of the American Psychological Association.

Principle D: Justice
Psychologists recognize that fairness and justice entitle all persons to access to and benefit from the contributions of psychology and to equal quality in the processes, procedures, and services being conducted by psychologists. Psychologists exercise reasonable judgment and take precautions to ensure that their potential biases, the boundaries of their competence, and the limitations of their expertise do not lead to or condone unjust practices.

Forensic custody evaluations typically cost between $20,000 to $40,000 and take between six to nine months to complete. This denies access to mental health involvement to parents and children from lower socioeconomic levels who cannot afford the high cost of a forensic custody evaluation.

Clinical psychology can return a clinical diagnostic risk assessment of possible child abuse with second-opinion consultation for around $5,000 in four to six weeks.

Attorneys and litigation are immensely expensive, damaging the child’s future by draining parental financial resources into litigation, money that should be focused on raising the child and family. Court involvement needs to be structured to anticipate the likely presence of narcissistic, borderline, and dark personalities in the family courts, and the legal system should have a structured approach to responding to predictable pathology, i.e., for obtaining a proper diagnostic risk assessment for possible child abuse.

A structured legal approach to responding to child custody conflict in the family courts would reduce financial costs, making reasonable court-involvement available all socioeconomic levels and to pro se parents.

Research indicates that approximately 90% of all divorcing families resolve the child’s custody schedule without court involvement, and that only 10% become “high-conflict” custody cases in the courts.

From Saini & Birnbaum (2007): “Hetherington, Stanley-Hagan and Anderson (1989) note that 90 percent of custody matters are settled before the parents even reach the courts.” (p. 19)

Saini & Birnbaum (2007): “The term ‘high conflict’ has been used as an umbrella term to describe parents who experience high rates of litigation and relitigation, high degrees of anger and distrust, verbal, physical and emotional abuse, and ongoing difficulty in communicating and cooperating about the needs of their children (Johnston 1994). In fact, most estimates of high conflict families are based on ongoing litigation rates post separation/divorce. Mnookin and Kornhauser (1979) note that less than 10 per cent of parents remain in high conflict as evidenced by on-going litigation.

Research indicates that approximately 6% of the population has Narcissistic Personality Disorder (NPD), and that about 6% of the population have Borderline Personality Disorder (BPD).  Both are known to be high-conflict personalities.

From Stinson, et al: “Prevalence of lifetime NPD was 6.2%”

Stinson, et al., (2008). Prevalence, correlates, disability, and comorbidity of DSM-IV narcissistic personality disorder. Journal of Clinical Psychiatry. 1033-1045.

From Grant, el al: “Prevalence of lifetime BPD was 5.9%”

Grant, et al., (2008). Prevalence, correlates, disability and comorbidity of DSM-IV borderline personality disorder. Journal of Clinical Psychiatry. 533—545

The legal system should anticipate that approximately 10% of divorces will be high-conflict surrounding child custody, and that approximately 10% of cases will involved a narcissistic, borderline, or dark personality parent (a high-conflict parent).

Greenham & Childress (in submission):

The courts should anticipate and prepare for parental narcissistic, borderline, and dark personality pathology that will seek to manipulate the court’s decisions on child custody by making false allegations and inducing false pathology in the child.

A proper clinical diagnostic risk assessment for possible child abuse should be conducted in all cases of court-involved child custody conflict. At an estimated cost of around $5,000, a clinical diagnostic risk assessment is affordable to all socio-economic levels. The clinical diagnostic risk assessment should be to the differential diagnosis of:

1. 1. 1. Targeted Parent: possible child abuse by the targeted parent resulting in the child’s attachment pathology to that parent (a two-person attribution of causality).

If the targeted parent is abusive of the child, diagnose the child abuse and protect the child. Place the abusive parenting on a treatment plan and fix it, then restore the child’s healthy attachment bond to their parent.

1. 1. 2. Allied Parent: possible Child Psychological Abuse (DSM-5 V995.51) by the allied parent who has created a shared persecutory delusion and false attachment pathology in the child for the secondary gain of nullifying the court’s orders for child custody and manipulating the court’s custody decisions (a three-person triangle attribution of causality).

If the allied parent is psychologically abusing the child, diagnose the child abuse and protect the child. Recover the child’s healthy and normal-range development. Once the child’s recovery is stabilized, restore contact with the abusive parent with enough safeguards in place to ensure that the abuse does not resume when contact with the abusive parent is restored.

Sentence 4:

From the AFCC & NCJFCJ: “Children should have the opportunity to express their views in family justice matters that concern them.”

The child’s views and symptoms should be assessed within the context of a proper clinical diagnostic risk assessment for possible child abuse.

If there is no child abuse, then parents have the right to parent according to their cultural values, their personal values, and their religious values. In the absence of child abuse, to restrict either parent’s time and involvement with their child would damage the child’s attachment bond to that parent, thereby harming the child and harming that parent.

Seeking the child’s views on custody (i.e., a spousal conflict), will directly “triangulate” the child into the middle of the spousal conflict by asking the child to side with one parent’s side against the other parent’s side in the conflict. Triangulating the child into the spousal conflict is pathology and is exactly the WRONG thing to do.

When there is a “cross-generational coalition” of the child with an allied parent against the targeted parent, seeking the child’s views on any issue of spousal contention will be triggering the child’s coalition with one parent against the other – this is pathology.

The treatment for a “cross-generational coalition” is to de-triangulate the child by dis-empowering the child from issues of spousal conflict. To seek the child’s input on issues of spousal conflict will turn the child into a “custody prize” to be won by whichever parent better convinces the child to join that parent’s side in the spousal conflict issue. This is exactly the WRONG think to do, it is pathology to place the child in the middle of the spousal conflict.

The child’s views and symptoms should be assessed within the context of a proper clinical diagnostic risk assessment for possible child abuse.

If there is no child abuse, then parents have the right to parent according to their cultural values, their personal values, and their religious values, and psychologists and the courts should not be deciding which parent is the ‘better’ parent who ‘deserves’ to have the child based on arbitrary and ill-conceived criteria.

Children should NEVER testify against a parent. Children should never be made to betray either parent in testimony to a judge. The child’s views and symptoms should be collected during a proper risk assessment for possible child abuse, and the diagnostic and treatment information for the child and family should be presented to the court by the assessing clinical psychologist.

Sentence 5:

From the AFCC & NCJFCJ: “The stated views of children are not necessarily determinative of their best interests.”

The “stated views of children” are often symptoms of severe attachment pathology, possible child abuse, possible persecutory delusions shared with the allied parent, and a possible Factious Disorder Imposed on Another, i.e., a false attachment pathology imposed on the child by a narcissistic, borderline, or dark personality parent for the secondary gain of manipulating the court’s decisions on child custody by producing pathology in the child.

In all cases of court-involved child custody conflict, a proper risk assessment needs to be conducted to both sides of the differential diagnosis:

1. 1. • Targeted Parent: possible child abuse by the targeted parent resulting in the child’s attachment pathology to that parent (a two-person attribution of causality).

1. 1. • Allied Parent: possible Child Psychological Abuse (DSM-5 V995.51) by the allied parent who has created a shared persecutory delusion and false attachment pathology in the child for the secondary gain of nullifying the court’s orders for child custody and manipulating the court’s custody decisions (a three-person triangle attribution of causality).

Sentence 6:

From the AFCC & NCJFCJ: “There are multiple factors that may contribute to children expressing views that do not reflect their best interests.”

The “multiple factors” are called a “differential diagnoses” for the possible causes of the child’s symptoms.

From Wikipedia: “In healthcare, a differential diagnosis (abbreviated DDx) is a method of analysis of a patient’s history and physical examination to arrive at the correct diagnosis. It involves distinguishing a particular disease or condition from others that present with similar clinical features.”

The differential diagnoses (“multiple factors”) for court-involved child custody conflict are:

1. 1. • Targeted Parent: possible child abuse by the targeted parent resulting in the child’s attachment pathology to that parent (a two-person attribution of causality).

• • • Allied Parent: possible Child Psychological Abuse (DSM-5 V995.51) by the allied parent who has created a shared persecutory delusion and false attachment pathology in the child for the secondary gain of nullifying the court’s orders for child custody and manipulating the court’s custody decisions (a three-person triangle attribution of causality).

In all cases of court-involved child custody conflict, a proper clinical diagnostic risk assessment for possible child abuse needs to be conducted.

Sentence 7:

From the AFCC & NCJFCJ: “Family justice practitioners should understand the basis for the contact child’s expressed wishes and acknowledge their rights.”

What child “rights” should be acknowledged by the judges and psychologists? Is this a legitimate recommendation for “rights”? Or is this an “inverted hierarchy” of empowering the child to an elevated position above the authority of the “family justice practitioners”? What child rights need to be acknowledged? Identify them.

In the absence of child abuse, parents have the right to parent according to their cultural values, their personal values, and their religious values. If there is a concern for possible child abuse (i.e., “safety”), then a proper clinical diagnostic risk assessment for possible child abuse needs to be conducted.

There are four DSM-5 diagnoses of child abuse, Child Physical Abuse (V995.54), Child Sexual Abuse (V995.53), Child Neglect (V995.52), Child Psychological Abuse (V995.51). In all cases of court-involved child custody conflict, a proper clinical diagnostic risk assessment for possible child abuse needs to be conducted to the differential diagnosis of:

• • • Targeted Parent: possible child abuse by the targeted parent resulting in the child’s attachment pathology to that parent (a two-person attribution of causality.

• • • Allied Parent: possible Child Psychological Abuse (DSM-5 V995.51) by the allied parent who has created a shared persecutory delusion and false attachment pathology in the child for the secondary gain of nullifying the court’s orders for child custody and manipulating the court’s custody decisions (a three-person triangle attribution of causality).

Dr. Childress Notes 6.

Craig Childress, Psy.D.
Clinical Psychologist, CA PSY 18857

This is my fifth post of my line-by-line notes for the AFCC & NCJFCJ Joint Statement on Parent-Child Contact Problems.

Notes 5 is in response to the fourth sentence of the Problem Statement, and the first title in their recommended “considerations”.

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Line-by-Line Notes 5

From the AFCC & NCJFCJ:

“AFCC and NCJFCJ support transparent, informed, and deliberate dialogue and response to parent-child contact problems following separation and divorce, or when the parents have never resided together, by adhering to the following considerations:

1.  Adopt a child-centered approach”

Dr Childress Notes 5:

There is no such diagnostic pathology as “parent-child contact problems” that is supported by the research literature. It is a made-up new pathology proposal. Professional organizations should use professional-level constructs when discussing pathology (problems).

• • • The correct professional construct is attachment pathology.
    • The correct professional construct is child abuse.

From the AFCC & NCJFCJ: “transparent, informed, and deliberate dialogue and response…”

This statement is vague to the point of uselessness. Diagnosis guides the treatment “response”. Are they intervening with cancer or diabetes? First, identify what the problem is, i.e., first diagnose what the pathology is.

• • • We must first diagnose what the pathology is before we know how to treat it. We must first identify what the problem is before we know how to fix it.

Diagnose = identify
Pathology = problem
Treatment = fix it

Diagnosis is made based on a pattern-match of symptoms to diagnostic criteria.

• • • For “transparency” – clearly collect and document the relevant symptoms for the various differential diagnostic possibilities.

• • • For “informed” – apply the diagnostic criteria and the established scientific and professional knowledge of the discipline of psychology to the symptom evidence.

• • • For “deliberate dialogue” in professional psychology, seek a second-opinion on diagnoses based on the pattern-match of symptoms to diagnostic criteria.

From Improving Diagnosis: “Referral and Consultation. Clinicians may refer to or consult with other clinicians (formally or informally) to seek additional expertise about a patient’s health problem. The consult may help to confirm or reject the working diagnosis or may provide information on potential treatment options. If a patient’s health problem is outside a clinician’s area of expertise, he or she can refer the patient to a clinician who holds more suitable expertise. Clinicians can also recommend that the patient seek a second opinion from another clinician to verify their impressions of an uncertain diagnosis or if they believe that this would be helpful to the patient.”

Improving Diagnosis in Healthcare, a report from the National Academies of Science, Engineering, and Medicine: https://pubmed.ncbi.nlm.nih.gov/26803862/

In clinical psychology (and all of healthcare), diagnosis guides treatment. The appellate system for a disputed diagnosis in healthcare is a second opinion.

From the AFCC & NCJFCJ: “1.  Adopt a child-centered approach”

This is manipulative because it contains a false straw man implication that anyone opposing their position takes an approach that is harmful for the child. It assumes by implication that one side has a “child-centered approach” while the other side has the opposite, i.e., a self-centered approach. This is a false assertion by implication.

The framing by itself discounts opposing viewpoints as being “selfish and self-centered”. This is incorrect. It is a false implication.

Everyone wants what’s best for the child, they simply disagree as to what that is. To attribute a “child-centered approach” to your side and attribute by implication that the motivation of those who look at a broader context is a ‘self-centered approach’ is fundamentally wrong and manipulatively misguided.

Everyone wants what is best for the child. That is the truth. One side is not “child-centered” while the other side is “self-centered” by implication – that is a false framing.

The center should not be on the child or on the parent. The center should be on the truth. What is the accurate diagnosis of the problem in the family? Identify the pathology. Then develop a written treatment plan to fix it. That is a center based on the truth. What is the diagnosis?

Identify what the problem is. Diagnose what the pathology is.

The center for treatment should be on the family that surrounds the child, because a healthy or unhealthy family is the context in which the child develops. A “Child Centered Approach” within an unhealthy family with unhealthy parents is a misguided approach. A family-centered approach that provides the child with a healthy family context for development is the proper treatment-oriented approach to conflict resolution within the family.

The focus should be on the family, and on the restoration of healthy attachment bonds in the parent-child relationships within the family context. If there is parental pathology distorting the family relationships, then a focus on the parental pathology and its impact becomes the focus.

A “Child-Centered Approach” misunderstands how families function, and how children become caught up and “triangulated” into the spousal conflict.

From the Bowen Center: “A triangle is a three-person relationship system. It is considered the building block or “molecule” of larger emotional systems because a triangle is the smallest stable relationship system. A two-person system is unstable because it tolerates little tension before involving a third person. A triangle can contain much more tension without involving another person because the tension can shift around three relationships. If the tension is too high for one triangle to contain, it spreads to a series of “interlocking” triangles. Spreading the tension can stabilize a system, but nothing is resolved.”

The Bowen Center Triangles: https://www.thebowencenter.org/triangles

Is the cause of the child’s attachment pathology a two-person parent-child problem caused by the targeted parent? Or is the cause of the child’s attachment pathology a three-person parent-child-parent triangle (a cross-generational coalition of the child with one parent against the other parent).

If the child is being abused by a parent, then diagnose the child abuse and protect the child.

In the absence of child abuse, parents have leadership responsibilities within the family.

From Minuchin: “Children and parents, and sometimes therapists, frequently describe the ideal family as a democracy. But they mistakenly assume that a democratic society is leaderless, or that a family is a society of peers. Effective functioning requires that parent and children accept the fact that the differentiated use of authority is a necessary ingredient for the parental subsystem. This becomes a social training lab for the children, who need to know how to negotiate in situations of unequal power.” (p. 58)

In the absence of child abuse, parents have the right to parent according to their cultural values, their personal values, and their religious values. In the absence of child abuse, each parent should have as much time and involvement with the child as possible.

Is there child abuse? That is the relevant question for psychologists and the courts.

Psychologists and the courts should NOT be deciding on who ‘deserves’ to be a parent based on arbitrary and unsupported criteria. In the absence of child abuse, parents have the right to be parents in accord with their cultural values, personal values, and religious values. The relevant consideration for psychologists and the courts is whether there is child abuse.

The concern for professional psychology and the courts is possible child abuse whenever there is severe attachment pathology being displayed by the child. In ALL cases of severe attachment pathology surrounding divorce, a proper risk assessment for possible child abuse needs to be conducted to the differential diagnosis of:

• • • Possible child abuse by the targeted parent creating the child’s attachment pathology toward that parent, i.e., a two-person attribution of causality,

• • • Possible Child Psychological Abuse (DSM-5 V995.51) by the allied narcissistic-borderline-dark personality parent who is creating a shared persecutory delusion in the child that then destroys the child’s attachment bond to the other parent, for the secondary gain of manipulating the court’s decision surrounding child custody – i.e., creating a false attachment pathology imposed on the child – a Factitious Disorder Imposed on Another (DSM-5 300.19), i.e., a three-person triangle attribution of causality.

The potential family pathological concern is that the child is being “triangulated” into the spousal conflict by the formation of a “cross-generational coalition” of the child with the allied parent against the targeted parent, resulting in an “emotional cutoff” in the child’s attachment pathology toward the parent, as represented in this Structural family diagram from Minuchin,

A characteristic symptom created by a “cross-generational coalition” of the child with the allied parent is called an “inverted hierarchy” in which the child becomes over-empowered by the alliance with one parent to an elevated position in the family hierarchy above the targeted parent, from which the child judges the adequacy of the targeted parent as if the parent was the child and the child was the parent.

This “inverted hierarchy” created by a cross-generational coalition of the child with one parent against the other needs to be properly assessed, and a strictly “child-centered” rather than a broader “family-centered” focus runs the risk of misunderstanding the child’s symptoms within the  broader family context.

Based on the application of constructs and principles from family systems therapy, a “child-centered” approach will potentially mask and hide the family pathology behind the cloak of a limited-scope focus on the child’s induced symptoms. A family-centered approach that recognizes the importance of healthy parent-child attachment bonds and the potential triangulation of the child into the family conflict is recommended.

From Stone, Buehler, & Barber: “The concept of triangles “describes the way any three people relate to each other and involve others in emotional issues between them” (Bowen, 1989, p. 306).  In the anxiety-filled environment of conflict, a third person is triangulated, either temporarily or permanently, to ease the anxious feelings of the conflicting partners. By default, that third person is exposed to an anxiety-provoking and disturbing atmosphere. For example, a child might become the scapegoat or focus of attention, thereby transferring the tension from the marital dyad to the parent-child dyad. Unresolved tension in the marital relationship might spill over to the parent-child relationship through parents’ use of psychological control as a way of securing and maintaining a strong emotional alliance and level of support from the child. As a consequence, the triangulated youth might feel pressured or obliged to listen to or agree with one parents’ complaints against the other. The resulting enmeshment and cross-generational coalition would exemplify parents’ use of psychological control to coerce and maintain a parent-youth emotional alliance against the other parent (Haley, 1976; Minuchin, 1974).” (Stone, Buehler, & Barber, 2002, p. 86-87)

The construct of “child-centered” also fails to adequately consider parental psychological control of the child, in which the child is coerced and manipulated into sharing the beliefs of the allied parent (as noted by Stone, Buehler, & Barber above).

Psychological Control

The manipulative psychological control of the child by a parent is a scientifically established family relationship pattern in dysfunctional family systems. In his book regarding parental psychological control of children, Intrusive Parenting: How Psychological Control Affects Children and Adolescents, published by the American Psychological Association, Brian Barber and his colleague, Elizabeth Harmon, identify over 30 empirically validated scientific studies that have established the construct of parental psychological control of children.

Barber, B. K. (Ed.) (2002). Intrusive parenting: How psychological control affects children and adolescents. Washington, DC: American Psychological Association.

In Chapter 2 of Intrusive Parenting: How Psychological Control Affects Children and Adolescents, Brian Barber and Elizabeth Harmon provide the following definition for the construct of parental psychological control of the child:

From Barber & Harmon: “Psychological control refers to parental behaviors that are intrusive and manipulative of children’s thoughts, feelings, and attachment to parents. These behaviors appear to be associated with disturbances in the psychoemotional boundaries between the child and parent, and hence with the development of an independent sense of self and identity.” (Barber & Harmon, 2002, p. 15)

Barber, B. K. and Harmon, E. L. (2002). Violating the self: Parenting psychological control of children and adolescents. In B. K. Barber (Ed.), Intrusive parenting (pp. 15-52). Washington, DC: American Psychological Association.

According to Stone, Bueler, and Barber:

Stone, Bueler, & Barber: “The central elements of psychological control are intrusion into the child’s psychological world and self-definition and parental attempts to manipulate the child’s thoughts and feelings through invoking guilt, shame, and anxiety.  Psychological control is distinguished from behavioral control in that the parent attempts to control, through the use of criticism, dominance, and anxiety or guilt induction, the youth’s thoughts and feelings rather than the youth’s behavior.” (Stone, Buehler, & Barber, 2002, p. 57)

Stone, G., Buehler, C., & Barber, B. K.. (2002) Interparental conflict, parental psychological control, and youth problem behaviors. In B. K. Barber (Ed.), Intrusive parenting: How psychological control affects children and adolescents. Washington, DC: American Psychological Association.

Soenens and Vansteenkiste (2010) describe the various methods used to achieve parental psychological control of the child:

From Soenens and Vansteenkiste: “Psychological control can be expressed through a variety of parental tactics, including (a) guilt-induction, which refers to the use of guilt inducing strategies to pressure children to comply with a parental request; (b) contingent love or love withdrawal, where parents make their attention, interest, care, and love contingent upon the children’s attainment of parental standards; (c) instilling anxiety, which refers to the induction of anxiety to make children comply with parental requests; and (d) invalidation of the child’s perspective, which pertains to parental constraining of the child’s spontaneous expression of thoughts and feelings.” (Soenens & Vansteenkiste, 2010, p. 75)[4]

Soenens, B., & Vansteenkiste, M. (2010). A theoretical upgrade of the concept of parental psychological control: Proposing new insights on the basis of self-determination theory. Developmental Review, 30, 74–99.

A proposal for a “child-centered” approach will need to include the assessment of a potentially compromised “independent sense of self and identity” with the child due to the manipulative psychological control of the child by the allied parent.

From Kerig: “Rather than telling the child directly what to do or think, as does the behaviorally controlling parent, the psychologically controlling parent uses indirect hints and responds with guilt induction or withdrawal of love if the child refuses to comply. In short, an intrusive parent strives to manipulate the child’s thoughts and feelings in such a way that the child’s psyche will conform to the parent’s wishes.” (p. 12)

Kerig, P.K. (2005). Revisiting the construct of boundary dissolution: A multidimensional perspective. Journal of Emotional Abuse, 5, 5-42.

It is always “child-centered” to protect the child from child abuse. A “child-centered” approach would also entail conducting a proper risk assessment for all cases of severe attachment pathology displayed by a child toward a parent to the differential diagnosis of:

• • • Possible child abuse by the targeted parent creating the child’s attachment pathology toward that parent, i.e., a two-person attribution of causality),

• • • Possible Child Psychological Abuse (DSM-5 V995.51) by an allied narcissistic-borderline-dark personality parent who is creating a shared persecutory delusion in the child that then destroys the child’s attachment bond to the other parent, for the secondary gain of manipulating the court’s decision surrounding child custody – a false attachment pathology imposed on the child – a Factitious Disorder Imposed on Another (DSM-5 300.19), i.e., a three-person triangular attribution of causality.

Protecting children from child abuse is always “child-centered”.

Finally, a “child-centered” approach disregards the potential IPV spousal emotional and psychological abuse of the targeted parent by the allied parent using the child as the weapon, a DSM-5 diagnosis of V995.82. Protecting all persons from all forms of abuse is required by professional duty to protect obligations.

In all cases of severe attachment pathology surrounding court-involved family conflict, a proper risk assessment for possible spousal emotional and psychological abuse of one spouse-and-parent by the other spouse-and-parent using the child as the weapon needs to be conducted.

All mental health professionals have duty to protect obligations for all persons for all forms of abuse.

A family-centered approach is recommended, and for a variety of reasons, a child-centered approach is contra-indicated – except to the extent that protecting children from child abuse is always child-centered.

When child abuse is a considered diagnosis, a proper risk assessment needs to be conducted.

In the absence of child abuse, parents have the right to parent according to their cultural values, their personal values, and their religious values.

The relevant issues for the psychologists and the court is whether there is child abuse or spousal abuse using the child as the weapon. A proper risk assessment for both of these possible abuse diagnoses needs to occur.

Dr. Childress Notes 5.

Craig Childress, Psy.D.
Clinical Psychologist, CA PSY 18857

 

This is my fourth post of my line-by-line notes for the AFCC & NCJFCJ Joint Statement on Parent-Child Contact Problems.

Notes 4 is in response to the third sentence of the Problem Statement

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Line-by-Line Notes 4

From the AFCC & NCJFCJ:

“This problem may be exacerbated by (1) gendered and politicized assumptions that either parental alienation or intimate partner violence is the determinative issue; (2) contradictory rhetoric about the application of research findings and the efficacy of interventions; (3) indiscriminate use of services; and (4) a lack of understanding of different perspectives, education among family law practitioners, and resources.”

Dr Childress Notes 4:

From the AFCC & NCJFCJ: “(1) gendered and politicized assumptions that either parental alienation or intimate partner violence is the determinative issue.”

There is no such pathology as “parental alienation” and the use of that construct in a professional capacity is substantially beneath professional standards of practice in clinical psychology, and is in violation of Standard 2.04 Bases for Scientific and Professional Judgements of the APA ethics code.

2.04 Bases for Scientific and Professional Judgments
Psychologists’ work is based upon established scientific and professional knowledge of the discipline

Professional organizations should abide by ethical Standards of practice. The AFCC and NCJFCJ have failed in this obligation. There is no such pathology as “parental alienation.”

Note: the AFCC and NCJFCJ identify a non-existent pathology and IPV (intimate partner violence) but they fail to note possible child abuse, including possible psychological child abuse by a pathological narcissistic-borderline-dark personality parent, as a possible “determinative issue” of the pathology in the family courts. Why did they omit possible child abuse as a possible “determinative issue” (particularly possible Child Psychological Abuse – DSM-5 V995.51) for possible pathology concerns?

The family conflict in the courts potentially also represents a DSM-5 diagnosis of spousal emotional and psychological abuse of the targeted parent by the allied parent using the child as the weapon, a DSM-5 diagnosis of V995.82 Spouse or Partner Abuse Psychological – which would represent IPV of the targeted parent by the allied parent using the child as the weapon.

IPV is a possible “determinative issue” in creating the pathology. In fact, it may be a driving issue.

Attachment pathology is always caused by pathogenic parenting, the diagnostic question is which parent? When possible child abuse is a considered diagnosis, a proper risk assessment needs to be conducted.

In all cases of severe attachment  pathology displayed by a child, a proper risk assessment for possible child abuse needs to be conducted to the differential diagnosis of:

• • • Possible child abuse by the targeted parent creating the child’s attachment pathology toward that parent (identify it, treat it, resolve it and restore the child’s attachment bond to the parent),

• • • Possible Child Psychological Abuse (DSM-5 V995.51) by the allied narcissistic-borderline-dark personality parent who is creating a shared persecutory delusion in the child that then destroys the child’s attachment bond to the other parent for the secondary gain of manipulating the court’s decision surrounding child custody – a false attachment pathology imposed on the child – a Factitious Disorder Imposed on Another (DSM-5 300.19)

The Problem Statement of the AFCC and NCJFCJ has lost its focus on the issue of importance, i.e., is there child abuse by a parent? Is the child at risk? Is a child protection response needed?

From the AFCC & NCJFCJ: “(2) contradictory rhetoric about the application of research findings and the efficacy of interventions;”

All psychologists should be applying the same information, i.e.., the “established scientific and professional knowledge of the discipline,” as the bases for thiir professiona judgments.

2.04 Bases for Scientific and Professional Judgments
Psychologists’ work is based upon established scientific and professional knowledge of the discipline

Standard 2.04 Bases of Scientific and Professional Judgments requires – mandatory – that the “established scientific and professional knowledge of the discipline” be applied as the bases for professional judgements.

Google mandatory: required by law or rules; compulsory.

Google required: officially compulsory, or otherwise considered essential; indispensable.

Google indispensable: absolutely necessary.

All psychologists should be applying exactly the same information (the best), to reach exactly the same conclusions (accurate), and make exactly the same recommendations (effective) based on the application of the “established scientific and professional knowledge of the discipline.” If two doctors disagree on a diagnosis, that is a serious problem for one of the doctors because it means they are wrong. That’s called a misdiagnosis, and that’s bad for a doctor.

The established scientific and professional knowledge of the discipline that is required to be applied as the bases for professional judgmens is:

• • • Attachment – Bowlby and others
    • Family systems therapy – Minuchin and others
    • Personality disorders – Linehan and others
    • Complex trauma – van der Kolk and others
    • Child development – Tronick and others
    • Self psychology – Kohut and others
    • DSM-5 diagnostic system & delusional thought disorders

If there is concern about the research or professional constructs being used in any of the above domains of knowledge, then specify what concerns exist in the attachment research, in the family systems principles and constructs used, in the personality disorder research applied, in the research on child abuse and complex trauma, in the child development research, in Kohut’s psychoanalytic model of child psychological development, or in the diagnostic criteria surrounding delusional thought disorders and Factitious Disorder Imposed on Another.

Be specific. What professional knowledge is not being applied appropriately, or being misapplied, from the “established scientific and professional knowledge of the discipline.”

This is the professional action required:

1, Document the child’s symptoms and surrounding family context.

2. Apply the diagnostic criteria for possible child abuse by the targeted parent – i.e., for Child Physical Abuse (V995.54), Child Sexual Abuse (V995.53), Child Neglect (V995.52), Child Psychological Abuse (V995.51).

3. Apply the diagnostic criteria for possible Child Psychological Abuse by the allied parent, i.e., creating a false attachment pathology and shared persecutory delusion in the child.

From the APA: “Persecutory Type: delusions that the person (or someone to whom the person is close) is being malevolently treated in some way.”

If the child is not being “malevolently treated in some way” by the normal-range parenting of the targeted parent, then rate the child’s false belief using the Brief Psychiatric Rating Scale (BPRS), “one of the oldest, most widely used scales to measure psychotic symptoms” (Wikipedia: BPRS: https://en.wikipedia.org); Item 11 Unusual Thought Content.

BPRS (Ventura, Lukoff, Nuechterlein, Liberman) https://www.researchgate.net/publication/284654397_Brief_Psychiatric_Rating_Scale_Expanded_version_40_Scales_anchor_points_and_administration_manual

In my clinical opinion, a BPRS rating should be obtained for child symptom severity for ALL court-involved evaluations of parent-child relationship conflict on the following items: Item 2 Anxiety, Item 3 Depression, Item 4 Suicidality (if warranted), Item 5 Guilt, Item 6 Hostility, Item 9 Susiciousness, Item 11 Unusual Thought Content.

If there is concern about the information being relied upon, then rely upon the “established scientific and professional knowledge of the discipline.” Document the child’s symptoms. Apply the diagnostic criteria for the respective differential diagnoses under consideration that could be causing the child’s symptoms. Diagnose the pathology in the family – identify the problem in the family – and place the problem (pathology) on a written treatment plan to fix it.

Google WikiHow Mental Health Treatment Plans

For personality disorder pathology, I recommend Dialectic Behavior Therapy (DBT; Linehan) as the organizing treatment structure for the family therapy, informed by attachment-related principles and treatment approaches (e.g., Tronick breach-and-repair sequence, Emotionally Focused Therapy; Johnson).

Treatment is based on diagnosis. The treatment for cancer is different than the treatment for diabetes. What diagnosis is being treated in the family courts? Is it an accurate diagnosis or a misdiagnosis? If we treat cancer with insulin then the patient dies from the misdiagnosed cancer. The appellate system for a disputed diagnosis is second opinion.

From Improving Diagnosis: “Clinicians may refer to or consult with other clinicians (formally or informally) to seek additional expertise about a patient’s health problem. The consult may help to confirm or reject the working diagnosis or may provide information on potential treatment options. If a patient’s health problem is outside a clinician’s area of expertise, he or she can refer the patient to a clinician who holds more suitable expertise. Clinicians can also recommend that the patient seek a second opinion from another clinician to verify their impressions of an uncertain diagnosis or if they believe that this would be helpful to the patient.”

Improving Diagnosis in Healthcare, a report from the National Academies of Science, Engineering, and Medicine: https://pubmed.ncbi.nlm.nih.gov/26803862/

There is substantial research and professional knowledge that can be universally agreed on and applied to understanding and treating the attachment pathology in the family courts. This represents the “established scientific and professional knowledge of the discipline.”

If it is not known or is not being applied by the forensic psychologists in court-involved practice, then that speaks to the deficient standards of practice in forensic psychology and raises prominent concerns for compliance with Standard 2.01 Boundaries of Competence related to the following domains:

• • • Attachment pathology
      • When assessing, diagnosing (identifying), and treating (fixing) severe attachment pathology displayed by the child.

• • • Delusional thought disorders
      • When assessing, diagnosing (identifying), and treating (fixing) possible delusional thought disorder pathology in the parent being imposed on the child.

• • • Narcissistic, borderline, and dark personalities
      • When assessing, diagnosing (identifying), and treating (fixing) the potential impact on family relationships of parental personality pathology.

• • • Family systems therapy and constructs
      • When assessing, diagnosing (Identifying), and treating (fixing) family conflict.

Does the Joint Statement by the AFCC & NCJFCJ meet professional Standards for Competence in the relevant domains of pathology, i.e., Standards 2.01 Boundaries of Competence, for the involved psychologists, and with regard to Standard 2.04 Bases for Scientific and Professional Judgments regareding the established scientific and professional knowledge they applied or failed to apply as the bases for their professional judgments?

From the AFCC & NCJFCJ: “(3) indiscriminate use of services;”

Mental health services should accurately diagnose the pathology and effectively treat it and resolve it. Over-use of mental health services should not be an issue because the pathology should be accurately diagnosed, treated, and resolved when it encounters the mental health system.

If pathology is not being effectively resolved when it enters the mental health system, that’s a problem in the mental health system not in the use of services by the clients.

“Indiscriminate use” is not the client’s concern, the existence of this feature suggests a breakdown in the ability of the “services” to effectively resolve the pathology (problem) on the initial encounter.

Diagnosis guides treatment. The treatment for cancer is different than the treatment for diabetes. What diagnosis for the family conflict pathology is guiding the “use of services” in the family courts?

From the AFCC & NCJFCJ: “(4) a lack of understanding of different perspectives, education among family law practitioners, and resources.”

These sound like personal opinions. Citations please to the research support for all four assertions:

• • That the problem in the family courts is being exacerbated by assumptions that either parental alienation [note there is no such diagnostic entity] or Intimate Partner Violence is the determinative issue;

• • • Why was possible child abuse omitted from consideration as a “determinative issue”?

• • • Where is the research support for this statement?

• That the problem in the family courts is exacerbated by rhetoric about the application of research findings and the efficacy of interventions;

• • • Where is the research support for this statement?

• That the problem in the family courts is exacerbated by indiscriminate use of services;

• • • Where is the research support for this statement?

• That the problem in the famiy courts is exacerbated by a lack of understanding of different perspectives, education among family law practitioners, and resources.

• • • Where is the research support for this statement?

This Problem Statement appears to be unsupported personal opinions of whoever is on the committee drafting the Joint Statement from the AFCC and NCJFCJ.

In professional psychology, a “lack of understanding…” is called incompetence. In professional psychology, a “lack of understanding” represents deficient professional practice. In professional psychology, a “lack of understanding” is called misdiagnosis.

All psychologists are expected to understand the pathology they work with (Standard 2.01 Boundaries of Competence) or else they shouldn’t be working with it.

All doctors should be applying exactly the same knowledge (the best) to reach exactly the same conclusions (accurate), and apply exactly the same treatments (effective). Psychologists are required to be competent by their education, training, and experience in the pathology they are working with (Standard 2.01 Boundaries of Competence) and to undertake ongoing efforts to maintain their competence, Standard 2.03 Maintaining Competence.

2.01 Boundaries of Competence
(a) Psychologists provide services, teach, and conduct research with populations and in areas only within the boundaries of their competence, based on their education, training, supervised experience, consultation, study, or professional experience.

2.03 Maintaining Competence
Psychologists undertake ongoing efforts to develop and maintain their competence.

The professional standard for competence with a pathology in clinical psychology is to know everything there is to know about the pathology, and then read journals to remain current.

It sounds like the AFCC & NCJFCJ are identifying professional incompetence, i.e., a “lack of understanding” due to inadequate “education” among the various professionals. Psychological pathology is the domain of psychologists. The psychologists should know what they are doing. There should be no “lack of understanding” displayed by the psychologists, and their education and training level should be appropriate to the pathology they are working with.

It sounds like the AFCC & NCJFCJ are offering the unsupported personal opinions of the committee members. A review of the psychologists’ vitaes on the committee is warranted to examine for their competence relative to Standard 2.01 in the following domains:

• • • Attachment pathology
      • When assessing, diagnosing (identifying), and treating (fixing) severe attachment pathology displayed by the child.

• • • Delusional thought disorders
      • When assessing, diagnosing (identifying), and treating (fixing) possible delusional thought disorder pathology in the parent being imposed on the child.

• • • Narcissistic, borderline, and dark personalities
      • When assessing, diagnosing (identifying), and treating (fixing) the potential impact on family relationships of parental personality pathology.

• • Family systems therapy and constructs
    • • When assessing, diagnosing (Identifying), and treating (fixing) family conflict.

Does the AFCC & NCJFCJ Joint Statement meet Standards for professional practice, or does it instead represent personal opinions offering “contradictory rhetoric about the application of research findings and the efficacy of interventions”?

Dr. Childress Notes 4.

Craig Childress, Psy.D.
Clinical Psychologist, CA PSY 18856

This is my third post of my line-by-line notes for the AFCC & NCJFCJ Joint Statement on Parent-Child Contact Problems.

Notes 3 is in response to the second sentence of the Problem Statement

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Line-by-Line Notes 3

From the AFCC & NCJFCJ:

“Children are at greater risk when parent-child contact problems are not effectively addressed and when family law professionals and others echo and intensify the polarization within the family.”

Dr Childress Notes 3:

There is no such pathology as “parent-child contact problems” – a professional Joint Statement should use professional-level knowledge and constructs to describe pathology. What is the professional-level description of the pathology they are describing?

• • • The correct professional construct is attachment pathology.

• • • The correct professional construct is child abuse.

If there are risks to the child as they clearly assert, then the professional concern is one of possible child abuse and a proper risk assessment needs to be conducted.

Why are professional organizations hiding the pathology of possible child abuse from professional-discussion by using euphemisms? When possible child abuse is a considered diagnosis, this should be clearly stated, discussed, and professionally addressed.

When there is a risk, that means there is a potential dangerous pathology involved (suicide, homicide, or abuse). In all cases where there is a potential risk, a proper risk assessment needs to be conducted.

Risk Assessment

A risk assessment is conducted when any of three types of dangerous pathology are presented by a client, suicide, homicide, or abuse (child, spousal, elder). The type of risk assessment depends on the type of danger involved, such as a suicide risk assessment when the client expresses suicidal thoughts (i.e., an assessment of prior history, current plan, recent loss, means, etc.).

There are four diagnoses of child abuse in the Child Maltreatment section of the DSM-5, each of these warrants a proper risk assessment; Child Physical Abuse (V995.54), Child Sexual Abuse (V995.53), Child Neglect (V995.52), Child Psychological Abuse (V995.51). All of these child abuse diagnoses are equivalent in the severity of the damage they cause to the child, they differ only in the type of damage done, not in the severity of damage done to the child. Psychological child abuse is devastating, it destroys the child from the inside out.

A suspicion of child physical, sexual, or neglect abuse is a mandated report to Child Protective Services (CPS) to allow their trained assessment professionals to conduct a proper risk assessment for these types of child abuse, and then to take the proper child protection steps when warranted. Mental health professionals in the community are prohibited from conducting the risk assessment themselves for these forms of child abuse, and they are mandated to refer to Child Protective Services (CPS) to ensure a proper assessment and the proper protection of the forensic evidence if needed.

Psychological child abuse, however, is not a mandated report, it is a “permitted” report to CPS, but not required. Psychological child abuse (i.e., creating severe pathology in the child through aberrant and distorted parenting) is more difficult to assess and diagnose, and typically requires a higher level of training than is available to the CPS professionals who are more focused on child physical, sexual, and neglect abuse.

The assessment for possible child psychological abuse requires a higher level of professional knowledge in attachment pathology, complex trauma, personality pathology, and thought disorders. Since psychological child abuse is not a mandated CPS report, this allows the involved mental health professionals to conduct the risk assessment for psychological child abuse, thereby allowing CPS to remain focused on identifying the other more overt forms of child abuse.

The professional concern with child psychological abuse is the creation of a thought disorder in the child, an induced persecutory delusion, by the aberrant and distorted parenting practices of the allied parent. A delusion is a fixed and false belief that is maintained despite contrary evidence. The type of delusion of concern is a potential persecutory delusion, i.e., a fixed and false belief in supposed “victimization.”  The American Psychiatric Association provides the definition of a persecutory delusion:

From the APA: “Persecutory Type: delusions that the person (or someone to whom the person is close) is being malevolently treated in some way.” (American Psychiatric Association, 2000)

Creating a shared persecutory delusion with a child that then destroys the child’s attachment bond to the other parent represents a DSM-5 diagnosis of V995.51 Child Psychological Abuse. The assessment for thought disorder pathology (delusions) is a Mental Status Exam of thought and perception conducted with the child and allied parent. Obtaining direct observation of the symptoms displayed in the parent-child relationship would confirm the diagnosis from the Mental Status Exam of thought and perception.

The clinical pathology of concern in the family is for possible unresolved trauma with a parent that then distorts their thinking and perception of situations, and that the parent’s persecutory delusion is then imposed on the child through aberrant and distorted parenting practices, creating a shared persecutory delusion (ICD-10 F24) relative to the other parent.

An additional clinical concern is that the allied parent is inducing this thought disorder in the child in order to (intentionally?) destroy the child’s attachment bond to the other parent in vengeful retaliation against the targeted parent for the failed marriage and divorce. Using the child as a weapon of spousal emotional and psychological abuse would represent Intimate Partner Violence (IPV; “domestic violence”), and would warrant a DSM-5 diagnosis of V995.82 Spouse or Partner Abuse, Psychological.

Creating a false attachment pathology (a factitious attachment disorder) and imposing that pathology on the child (on another) for the secondary gain of manipulating the court’s decisions surrounding child custody would represent a DSM-5 diagnosis of 300.19 Factitious Disorder Imposed on Another.

Google factitious: artificially created or developed.

By weaponizing the child into the spousal conflict, the allied parent creates such significant pathology in the child that it rises to the level of Child Psychological Abuse (DSM-5 V995.51). Spousal emotional and psychological abuse of the targeted parent by the allied parent using the child as the weapon is a second dangerous pathology of concern in the family that warrants a proper risk assessment.

Attachment pathology is only created by problematic parenting (pathogenic parenting), either from the targeted-rejected parent or from the allied parent. Whenever there is significant attachment pathology displayed by a child surrounding divorce, a proper diagnostic risk assessment needs to be conducted.

From AFCC & NCJFCJ: “Children are at greater risk..”

When children are at risk, a proper risk assessment needs to be conducted and psychologists’ duty to protect obligations are active.

In all cases of a dangerous pathology, including possible psychological child abuse (DSM-5 V995.51 Child Psychological Abuse) and possible spousal emotional and psychological abuse using the child as the weapon (DSM-5 V995.82 Spouse or Partner Abuse, Psychological), a proper risk assessment is required. Mental health professionals have duty to protect obligations.

The Joint Statement notes the “risk” associated with “parent=child contact problems.” This then clearly requires that a proper risk assessment for possible child abuse be conducted to the differential diagnosis of:

1. 1. • Possible child abuse by the targeted parent creating the child’s attachment pathology toward that parent (identify it, treat it, resolve it and restore the child’s attachment bond to the parent),

1. 1. • Possible Child Psychological Abuse (DSM-5 V995.51) by the allied narcissistic-borderline-dark personality parent who is creating a shared persecutory delusion in the child that then destroys the child’s attachment bond to the other parent for the secondary gain of manipulating the court’s decision surrounding child custody – a false attachment pathology imposed on the child – a Factitious Disorder Imposed on Another (DSM-5 300.19)

Note: “polarization” of perceptions is a psychiatric symptom called “splitting” and it is associated with both borderline and narcissistic personality pathology. When this polarization symptom of splitting spreads to the surrounding professionals, Marsha Linehan calls it “staff splitting.”

Parallel Process Staff Splitting (Childress, 2019)

https://drcraigchildressblog.com/2019/10/01/parallel-process-staff-splitting/

From Linehan:  “Staff splitting,” as mentioned earlier, is a much-discussed phenomenon in which professionals treating borderline patients begin arguing and fighting about a patient, the treatment plan, or the behavior of the other professionals with the patient.” (Linehan, 1993, p. 432)

From Linehan:  “Arguments among staff members and differences in points of view, traditionally associated with staff splitting, are seen as failures in synthesis and interpersonal process among the staff rather than as a patient’s problem… Therapist disagreements over a patient are treated as potentially equally valid poles of a dialectic.  Thus, the starting point for dialogue is the recognition that a polarity has arisen, together with an implicit (if not explicit) assumption that resolution will require working toward synthesis.” (Linehan, 1993, p. 432)

Linehan, M. M. (1993). Cognitive-Behavioral Treatment of Borderline Personality Disorder. New York, NY: Guilford

Why are professional organizations masking and covering-up the serious nature of the pathology in the family by using non-professional terms that hide what the pathology is, and by insead using euphemisms for child abuse (i.e., parent-child contact problems”)?

Is it because the forensic psychologists do not know the “established scientific and professional knowledge of the discipline” necessary for professional competence with this court-involved family conflict pathology?

The established scientific and professional knowledge of the discipline is:

• • • Attachment – Bowlby and others
    • Family systems therapy – Minuchin and others
    • Personality disorders – Linehan and others
    • Complex trauma – van der Kolk and others
    • Child development – Tronick and others
    • Self psychology – Kohut and others
    • DSM-5 diagnostic system & delusional thought disorders

Are the forensic psychologists working on this Joint Statement competent based on their education, training, and experience in the “established scientific and professional knowledge of the discipline” required for professional competence?

2.01 Boundaries of Competence
(a) Psychologists provide services, teach, and conduct research with populations and in areas only within the boundaries of their competence, based on their education, training, supervised experience, consultation, study, or professional experience.

A review of the vitaes of the forensic psychologists participating in this Joint Statement from the AFCC and NCJFCJ is warranted regarding Standard 2.01 Boundaries of Competence in the following domains of scientifically established professional knowledge:

• • Attachment pathology

When assessing, diagnosing (identifying), and treating (fixing) severe attachment pathology displayed by the child.

• • Delusional thought disorders

When assessing, diagnosing (identifying), and treating (fixing) possible delusional thought disorder pathology in the parent being imposed on the child.

• • Narcissistic, borderline, and dark personalities

When assessing, diagnosing (identifying), and treating (fixing) the potential impact on family relationships of parental personality pathology.

• Family systems therapy and constructs

When assessing, diagnosing (identifying), and treating (fixing) family conflict pathology.

When a child is at “risk,” all mental health professionals have duty to protect obligations and a proper risk assessment for possible child abuse needs to be conducted. Psychologists have duty to protect obligations.

Dr. Childress Notes 3.

Craig Childress, Psy.D.
Clinical Psychologist, CA PSY 18856

This is my second post of my line-by-line notes for the AFCC & NCJFCJ Joint Statement on Parent-Child Contact Problems.

Notes 2 is in response to the first sentence of the Problem Statement

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Line-by-Line Notes 2

From the AFCC & NCJFCJ:

“Problem Statement: The vast majority of separating and divorcing parents maintain safe, healthy, and positive relationships with their children; however, a small percentage of parent-child relationships remain strained and/or problematic.”

Dr Childress Notes 2:

An estimated 90% of post-divorce parents successfully resolve custody schedules without court involvement. Approximately 10% of families become “high-conflict” custody conflicts litigated in the court.

From Saini & Birnbaum (2007): “The term ‘high conflict’ has been used as an umbrella term to describe parents who experience high rates of litigation and relitigation, high degrees of anger and distrust, verbal, physical and emotional abuse, and ongoing difficulty in communicating and cooperating about the needs of their children (Johnston 1994). In fact, most estimates of high conflict families are based on ongoing litigation rates post separation/divorce. Mnookin and Kornhauser (1979) note that less than 10 per cent of parents remain in high conflict as evidenced by on-going litigation. Maccoby and Mnookin (1992) and Hetherington, Stanley-Hagan, and Anderson (1989) also used ongoing litigation rates as a measure when they described that 10 per cent of families remain in high conflict situations.”

Saini, M., & Birnbaum, R. (2007) Unraveling the label of “high conflict”: What factors really count in divorce and separated families. Journal of the Ontario Association of Children’s Aid Societies. 51(1), 14-20.

Research estimates a prevalence of narcissistic personality disorder in the general population at approximately 6%:

From Grant et al: “Prevalence of lifetime BPD was 5.9%”

Grant, et al., (2008). Prevalence, correlates, disability and comorbidity of DSM-IV borderline personality disorder. Journal of Clinical Psychiatry. 533—545

Research estimates a prevalence of borderline personality disorder in the general population at approximately 6%:

From Stinson et al: “Prevalence of lifetime NPD was 6.2%”

Stinson, et al., (2008). Prevalence, correlates, disability, and comorbidity of DSM-IV narcissistic personality disorder. Journal of Clinical Psychiatry. 1033-1045.

Both narcissistic and borderline personalities are known to be high-conflict personality styles.

Approximately 12% of the population have prominent narcissistic and borderline personality traits, and approximately 10% of divorces devolve into high-conflict custody litigation following divorce. It is reasonable to anticipate that a large percentage of the highly litigated custody conflict surrounding divorce involves either narcissistic or borderline personality pathology in a parent.

The potential presence of narcissistic or borderline personality pathology in a parent prominently raises the possibility of a dark personality parent, i.e., Dart Triad, Vulnerable Dark Triad, Dark Tetrad.

Dark Personalities and Induced Delusional Disorder (Greenham & Childress):

https://www.researchgate.net/publication/363197057_Dark_Personalities_and_Induced_Delusional_Disorder_The_Research_Gap_Underlying_a_Crisis_in_the_Family_and_Domestic_Violence_Courts

The collapse of narcissistic and borderline personality pathology into persecutory delusions is established knowledge.

From Millon: “Under conditions of unrelieved adversity and failure, narcissists may decompensate into paranoid disorders.  Owing to their excessive use of fantasy mechanisms, they are disposed to misinterpret events and to construct delusional beliefs. Unwilling to accept constraints on their independence and unable to accept the viewpoints of others, narcissists may isolate themselves from the corrective effects of shared thinking. Alone, they may ruminate and weave their beliefs into a network of fanciful and totally invalid suspicions. Among narcissists, delusions often take form after a serious challenge or setback has upset their image of superiority and omnipotence. They tend to exhibit compensatory grandiosity and jealousy delusions in which they reconstruct reality to match the image they are unable or unwilling to give up. Delusional systems may also develop as a result of having felt betrayed and humiliated. Here we may see the rapid unfolding of persecutory delusions and an arrogant grandiosity characterized by verbal attacks and bombast.” (Millon, 2011, pp. 407-408).

Millon. T. (2011). Disorders of personality: introducing a DSM/ICD spectrum from normal to abnormal. Hoboken: Wiley.

From Barnow et al: “This review reveals that psychotic symptoms in BPD patients may not predict the development of a psychotic disorder but are often permanent and severe and need careful consideration by clinicians. Therefore, adequate diagnosis and treatment of psychotic symptoms in BPD patients is emphasized… In conclusion, we therefore suggest that it is not a cognitive developmental deficit but rather a tendency to construe interpersonal relations as malevolent that characterizes BPD, and this may be shared with certain psychotic disorders. p. 187

Barnow, S., Arens, E. A., Sieswerda, S., Dinu-Biringer, R., Spitzer, C., Lang, S., et al  (2010). Borderline personality disorder and psychosis: a review. Current Psychiatry Reports, 12,186-195

From the APA: “Persecutory Type: delusions that he person (or someone to whom the person is close” is being malevolently treated in some way.” (American Psychiatric Association, 2000)

From Walters & Friedlander: “In some RRD families [resist-refuse dynamic], a parent’s underlying encapsulated delusion about the other parent is at the root of the intractability (cf. Johnston & Campbell, 1988, p. 53ff; Childress, 2013). An encapsulated delusion is a fixed, circumscribed belief that persists over time and is not altered by evidence of the inaccuracy of the belief.”

From Walters & Friedlander: “When alienation is the predominant factor in the RRD [resist-refuse dynamic}, the theme of the favored parent’s fixed delusion often is that the rejected parent is sexually, physically, and/or emotionally abusing the child. The child may come to share the parent’s encapsulated delusion and to regard the beliefs as his/her own (cf. Childress, 2013).” (Walters & Friedlander, 2016, p. 426)

Walters, M. G., & Friedlander, S. (2016). When a child rejects a parent: Working with the intractable resist/refuse dynamic. Family Court Review, 54(3), 424–445.

The potential Machiavellian manipulation associated with dark personalities and their collapse into persecutory delusions under stress raises prominent concerns for the creation of a false attachment pathology in the child by the pathogenic parenting of the dark personality parent for the secondary gain of manipulating the court’s decisions on child custody as a result of the induced pathology in the child – which would represent DSM-5 diagnoses of 300.19 Factitious Disorder Imposed on Another (a false attachment pathology and persecutory delusion imposed on the child) and V995.51 Child Psychological Abuse (i.e., creating a delusional thought disorder in the child that then destroys the child’s attachment bond to the other parent).

The differential diagnosis for severe attachment pathology in the child is possible child abuse, either 1) child abuse by the targeted parent creating the child’s attachment pathology toward this parent (a two-person attribution of causality), or 2) child psychological abuse (DSM-5 V995.51) by the allied parent who is creating a shared persecutory delusion and false attachment pathology in the child (a three-person triangular attribution of causality).

From Bowen Center: “A triangle is a three-person relationship system. It is considered the building block or “molecule” of larger emotional systems because a triangle is the smallest stable relationship system. A two-person system is unstable because it tolerates little tension before involving a third person. A triangle can contain much more tension without involving another person because the tension can shift around three relationships. If the tension is too high for one triangle to contain, it spreads to a series of “interlocking” triangles. Spreading the tension can stabilize a system, but nothing is resolved.”

From Bowen Center Triangles: https://www.thebowencenter.org/triangles

From Stone, Buehler, & Barber: “The concept of triangles “describes the way any three people relate to each other and involve others in emotional issues between them” (Bowen, 1989, p. 306). In the anxiety-filled environment of conflict, a third person is triangulated, either temporarily or permanently, to ease the anxious feelings of the conflicting partners. By default, that third person is exposed to an anxiety-provoking and disturbing atmosphere. For example, a child might become the scapegoat or focus of attention, thereby transferring the tension from the marital dyad to the parent-child dyad. Unresolved tension in the marital relationship might spill over to the parent-child relationship through parents’ use of psychological control as a way of securing and maintaining a strong emotional alliance and level of support from the child.  As a consequence, the triangulated youth might feel pressured or obliged to listen to or agree with one parents’ complaints against the other. The resulting enmeshment and cross-generational coalition would exemplify parents’ use of psychological control to coerce and maintain a parent-youth emotional alliance against the other parent (Haley, 1976; Minuchin, 1974).” (Stone, Buehler, & Barber, 2002, p. 86-87)

Minuchin structural diagram:

Standard 2.04 of the APA ethics code requires – mandatory – the application of the “established scientific and professional knowledge of the discipline” as the bases for professional judgements:

2.04 Bases for Scientific and Professional Judgments
Psychologists’ work is based upon established scientific and professional knowledge of the discipline

The established scientific and professional knowledge of the discipline is:

• • • Attachment – Bowlby and others
    • Family systems therapy – Minuchin and others
    • Personality disorders – Millon and others
    • Complex trauma – van der Kolk and others
    • Child development – Tronick and others
    • Self psychology – Kohut and others
    • DSM-5 diagnostic system & delusional thought disorders

In all cases of severe attachment pathology surrounding divorce, a proper risk assessment for possible child abuse needs to be conducted to the differential diagnosis of:

1) Possible child abuse by the targeted-rejected parent creating the child’s attachment pathology toward this parent (a two-person attribution of causality),

2) Possible child psychological abuse (DSM-5 V995.51) by the allied parent who is creating a shared persecutory delusion and false attachment pathology in the child (a three-person triangular attribution of causality) for the secondary gain of manipulating the court’s decisions for child custody.

Note that the opening sentence of the Problem Statement places the adjective “safe” as a primary parental obligation, with the clear implication that court-involved families may not be “safe” for the child. A proper risk assessment for possible child abuse to the differential diagnosis of “which parent” needs to be conducted with all cases of court-involved child custody conflict when there is severe attachment pathology displayed by the child.

Dr. Childress Notes 2.

Craig Childress, Psy.D.
Clinical Psychologist, CA PSY 18856

The Association of Family and Conciliation Courts (AFCC) and the National Council of Juvenile and Family Court Judges (NCJFCJ) have produced a joint statement on the attachment pathology in the family courts.

NCJFCJ and AFCC Approve Statement on Parent-Child Contact Problems

I  am going to provide a response from clinical psychology to this statement from the AFCC & NCJFCJ.

Whenever I review the professional work of forensic psychologists, I always approach my analysis in a structured way. I begin by taking line-by-line notes on my first reading – I don’t want to have to read it twice. I then rely on my notes for the opinions contained in my Summary Report.

I will be producing a Summary Report & Analysis of the AFCC and NCJFCJ Joint Statement on Parent-Child Contact Problems. In order to generate my Summary Report & Analysis from clinical psychology regarding this Joint Statement from the AFCC forensic psychologists and the juvenile and family court judges, I will be creating line-by-line notes from my first reading of their Joint Statement that will then serve as the basis for my opinions.

Rather than wait for the completion of my notes and writing of my Summary Report & Analysis, I will be posting my notes as they are generated. This will provide transparency to my analysis and support for my later Summary Report & Analysis, I will be posting to my blog my line-by-line review and commentary in a serial format as it is generated.

This post, Notes 1, represents the first notes generated. This is my response as a clinical psychologist to the title of their Joint Statement:

AFCC & NCJFCJ Joint Statement on Parent-Child Contact Problems

Judges are not professionally trained to diagnose or treat pathology. In this joint collaboration between judges and the forensic psychologists in the AFCC, the forensic psychologists are providing guidance to the judges regarding the assessment, diagnosis, and treatment of the attachment pathology (“parent-child contact problems”) in the family courts.

We must first diagnose what the pathology is before we know how to treat it. We must first diagnose what the problem is before we know how to fix it. It is the professional obligation of the forensic psychologists of the AFCC who are contributing to this joint statement with judges to provide appropriate professional guidance to the judges regarding the identification and treatment of pathology in the family.

Diagnose = identify
Pathology = problem
Treatment = fix it.

I will not be commenting on the legal aspects of this joint statement as I am trained as a doctor, I went to psychology graduate school, not law school. I’m a doctor, a licensed clinical psychologist, my domain is the diagnosis and treatment of pathology.

The judges and legal professionals on this Joint Statement were guided in their understanding of pathology by the forensic psychologists on the committee. I will be providing a second-opinion review and analysis of the work-product from the forensic psychologists, and their professional guidance provided to the judges and other legal professionals.

These are my line-by-line Notes 1 regarding the title of the Joint Statement on Parent-Child Contact Problems from the AFCC & NCJFCJ.

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Line-by-Line Notes 1

From the AFCC & NCJFCJ: “AFCC and NCJFC Joint Statement on Parent-Child Contact Problems”

Dr Childress Notes 1:

There is no such pathology as “parent-child contact problems” – there is no professional definition for that pathology.

• • • The correct professional-level construct is parent-child attachment pathology – attachment problems.

• • • The correct professional-level construct is child abuse.

There are two differential diagnoses for a severe attachment pathology displayed by the child:

1.) Child abuse by the targeted parent creating the child’s attachment pathology toward that parent.

If this is the case, identify what the child abuse is, treat it, resolve it, and restore the child’s attachment bond to the parent,

2.) Child Psychological Abuse (DSM-5 V995.51) by an allied narcissistic-borderline-dark personality parent who is creating a shared persecutory delusion in the child that then destroys the child’s attachment bond to the other parent for the secondary gain of manipulating the court’s decision surrounding child custody – a false attachment pathology imposed on the child – a Factitious Disorder Imposed on Another (DSM-5 300.19).

If this is the case, identify the child abuse and protect the child. Then restore the child’s healthy and normal-range development. Then, once the child’s healthy development has been recovered and stabilized, restore contact with the abusive parent with enough safeguards in place to protect the child from a return of the child abuse when contact with the abusive parent is reintroduced.

The differential diagnosis for severe attachment pathology surrounding divorce (“parent-child contact problems”) is child abuse by one parent or the other. Why are the professional organizations of the AFCC and NCJFCJ using euphemisms for child abuse?

By using non-professional constructs and euphemisms for child abuse, the AFCC and NCJFCJ are not identifying the child abuse – they are colluding in the cover-up of the child abuse occurring in the family courts by not clearly identifying the issue of child abuse.

When severe attachment pathology is displayed by a child, the differential diagnosis is child abuse one way or the other. Professionals and professional organizations should use real professional constructs and established diagnoses and should NOT make up euphemisms for child abuse to hide the child abuse from clear identification and disclosure.

The use of the construct of “parent-child contact problems” in a professional capacity is substantially beneath professional standards of practice in clinical psychology and is in violation of Standard 2.04 of the ethics code of the American Psychological Association that requires the application of the established scientific and professional knowledge of the discipline.

2.04 Bases for Scientific and Professional Judgments
Psychologists’ work is based upon established scientific and professional knowledge of the discipline

The established scientific and professional knowledge of the discipline is:

• • • Attachment – Bowlby and others
    • Family systems therapy – Bowen and others
    • Personality disorders – Millon and others
    • Complex trauma – van der Kolk and others
    • Child development- Tronick and others
    • Self psychology – Kohut and others
    • DSM-5 diagnostic system & delusional thought disorders

There is no such pathology as “parent-child contact problems” – it is severe attachment pathology and child abuse. The only diagnostic question is, which parent? The psychologists participating in this Joint Statement are in violation of ethical Standard 2.04 Bases for Scientific and Professional Judgments of the American Psychological Association.

There is no such pathology (problem) as “parent-child contact problems” defined in the professional literature with research support. It is a made-up diagnostic construct created by forensic psychologists from their imaginings and ignorance without professional research support.

Google ignorance: lack of knowledge or information

There is no such pathology as “parent-child contact problems” and the use of that diagnostic construct in a professional capacity is substantially beneath professional standards of practice in clinical psychology, and is in violation of Standard 2.04 Bases for Scientific and Professional Judgments of the APA ethics code.

Dr. Childress Notes 1.

Craig Childress, Psy.D.
Clinical Psychologist, CA PSY 18856

Amy Baker and Jennifer Harman are both research professors. They are not licensed clinical psychologists.

They have never been educated (doctoral courses) in clinical psychology, i.e., in the assessment, diagnosis, treatment of pathology. They have never been trained (two full years of supervised practice) in the assessment, diagnosis, or treatment of any pathology – ever in their lives.

They are not competent by their background education, training, and experience in the assessment, diagnosis, or treatment of any pathology.

Their competence is restricted to their research – only. They may discuss their research – but – they should NOT opine on the nature of pathology, it’s assessment, diagnosis, or treatment. The domain of clinical psychology, the assessment, diagnosis, and treatment of pathology, is beyond their boundaries of competence based on their education, training, and professional experience.

2.01 Boundaries of Competence
(a) Psychologists provide services, teach, and conduct research with populations and in areas only within the boundaries of their competence, based on their education, training, supervised experience, consultation, study, or professional experience.

Offering professional opinions on issues of pathology, its assessment, diagnosis, or treatment, is substantially beyond the boundaries of competence of Amy Baker and Jennifer Harman, and is in violation of Standard 2.01 Boundaries of Competence of the Ethical Principles of Psychologists and Code of Conduct of the American Psychological Association.

Clinical Psychology

I am a clinical psychologist with a doctoral degree in the coursework of  Clinical Psychology from Pepperdine University. I have the required one year of supervised pre-doctoral training from the APA accredited internship at Children’s Hospital of Los Angeles (CHLA), and I have two years of supervised post-doctoral training at CHLA.

This educational and training background then qualified me to sit for and pass the licensing examination for the state of California. That is the required education, training, and professional experience required to be a licensed clinical psychologist.

Amy Baker and Jennifer Harman completed none of that. They have none of the coursework in the assessment, diagnosis, and treatment of pathology. They have none of the required years of supervised training, pre-doctoral and post-doctoral. They have never taken the licensing exam because they have never been qualified to even apply to take it.

I am working currently working as a licensed clinical psychologist in the field of court-involved family conflict. This professional field involves personality disorder pathology, attachment pathology, complex trauma, and delusional thought disorders, These are the required domains of knowledge needed for clinical competence.

Amy Baker and Jennifer Harman are not competent by their background education, training, or experience in the clinical assessment, diagnosis, and treatment of any pathology.

Not attachment pathology in childhood.

Not personality disorder pathology.

Not family therapy.

Not child development.

Not delusional thought disorders.

Not child abuse and complex trauma.

As a licensed clinical psychologist, I AM competent by my education, training, and experience in all of those domains. I cite to my vitae for support:

Dr. Childress Vitae

I come to the family courts from my position as Clinical Director for a three-university assessment and treatment center for children ages zero-to-five in foster care, CPS was our primary referral source. I have background professional experience in attachment pathology, complex trauma, and child abuse. I also have background professional experience in the assessment and diagnosis of delusional thought disorders. I cite to my specialized expertise:

Dr. Childress Specialized Expertise

I also have specialized professional experience and training in the assessment and diagnosis of Factitious Disorder Imposed on Another (DSM-5 300.91; Munchausen by proxy) from my tenure at both Children’s Hospital of Los Angeles (CHLA) for three years of training, one pre-doctoral and two post-doctoral, and from my position on the medical staff at Children’s Hospital Orange County (Choc) as a pediatric psychologist.

As a licensed clinical psychologist, I also have professional background and experience in the assessment, diagnosis, and treatment of the attachment and family conflict pathology surrounding child custody conflict in the family courts, with presentations to the national conventions of the APA and AFCC (among others) regarding the pathology in the family courts, its assessment, diagnosis, and treatment.

From my role, position, and professional standing as a licensed clinical psychologist working directly with the pathology in the family courts, I am formally instructing Amy Baker and Jennifer Harman to stop using the construct of “parental alienation” in a professional capacity as this is a rejected diagnostic construct by the American Psychiatric Association for being substantially beneath professional standards of clinical practice.

The diagnostic model of “parental alienation” is the worst diagnostic model for a pathology ever proposed with substantial-substantial flaws as a diagnostic construct, which is why it was rejected as a diagnostic construct by the American Psychiatric Association in 2013 after a full and complete review.

The American Psychiatric Association said no.

The use of the rejected clinical diagnostic construct of “parental alienation” in a professional capacity is in violation of Standard 2.04 of the APA ethics code that requires – mandatory – that the “established scientific and professional knowledge” of professional psychology be applied as the bases for scientific and professional judgments.

2.04 Bases for Scientific and Professional Judgments
Psychologists’ work is based upon established scientific and professional knowledge of the discipline.

If, after having applied the “established scientific and professional knowledge of the discipline,” there remains some gap in understanding the pathology in the family courts using the scientifically established constructs and principles from – personality disorder pathology – attachment – complex trauma – family systems – child development – and delusional thought disorders – then, and ONLY then, are they allowed to propose a unique “new pathology” in mental health – so unique that it needs its own unique symptom identifiers.

Apply the “established scientific and professional knowledge of the discipline” first. Then, after applying the established knowledge first, if  a unique new pathology is needed to describe the pathology, then, and ONLY then, can they offer their proposal for a unique new pathology in mental health (that has been already been rejected by the American Psychiatric Association).

As a clinical psychologist treating the pathology in the family courts, the use of the construct of “parental alienation” substantially degrades the quality of clinical practice and clinical services that are received by parents and children in the family courts by encouraging professional ignorance and a professional disregard for ethical standards of practice.

The use of the construct of “parental alienation” degrades the quality of clinical services and clinical care received by parents, children, and the courts. It is essential and required that ALL psychologists rely ONLY on the “established scientific and professional knowledge of the discipline” as the bases for their professional judgments.

The relevant “established scientific and professional knowledge” of psychology is:

Attachment – Bowlby and others

Family systems therapy – Minuchin and others

Personality disorders (Dark) – Beck and others

Complex trauma – van der Kolk and others

Child development – Tronick and others

Self psychology – Kohut and others

Thought disorders – DSM-5 diagnostic system

This represents the “established scientific and professional knowledge of the discipline” that is required to be applied as the bases for scientific and professional judgments – first – not after – not instead of – FIRST.

By using the rejected diagnostic construct of “parental alienation” and promoting this made-up pathology to the general public, mental health professionals, and the court, Amy Baker and Jennifer Harman are degrading the quality of professional clinical services and clinical care received by children and parents in the family courts, and they are providing the courts with substantially inferior and professionally rejected professional information on which to base its decisions (rejected by the American Psychiatric Association as a legitimate clinical diagnostic pathology).

The use of the construct of “parental alienation” in a professional capacity degrades the quality of clinical services received by parents and children in the family courts – and is in violation of Standard 2.04 Bases for Scientific and Professional Judgments.

Neither Amy Baker nor Jennifer Harman are licensed – they have never been educated nor received the training necessary to be qualified for licensure. Neither is competent by their background education, training, or experience to opine on the assessment, diagnosis, or treatment of pathology – any pathology.

As a licensed clinical psychologist, I believe that there “may have been an ethical violation” of Standards 2.01 and 2.04 by another psychologist, Amy Baker and Jennifer Harman, when they opine on the assessment, diagnosis, and treatment of the pathology in the family courts, and when they rely on the rejected diagnostic construct of “parental alienation” as the bases for their scientific and professional judgments.

As are result of their being unlicensed, however, no recourse to their licensing boards is available for correction of their apparent violations to Standards 2.01 Boundaries of Competence when they opine on the assessment, diagnosis, or treatment of pathology, or for apparent violations to Standard 2.04 that degrades the quality of clinical services and clinical care received by parents and children.

Amy Baker and Jennifer Harman are not licensed clinical psychologists, so no corrective guidance is available from their licensing boards for their degradation of clinical care in the family courts because of apparently unethical practice (violations to Standards 2.01 & 2.04).

As a licensed clinical psychologist active in the family courts, I am therefore instructing Amy Baker and Jennifer Harman to discontinue using the construct of “parental alienation” in a professional capacity as it substantially degrades the quality of clinical services provided to parents and their children in the family courts, and to restrict themselves to the application of the “established scientific and professional knowledge” of professional psychology as the bases for their professional judgments first – not after – not instead of.

First.

The relevant established scientific and professional knowledge of the discipline is:

Attachment – Bowlby and others
Family systems therapy – Minuchin and others
Personality disorders – Beck and others
Complex trauma – van der Kolk and others
Child development – Tronick and others
Thought disorders – DSM-5 diagnostic system

Ethical practice is not optional. It is mandatory for all psychologists, including Amy Baker and Jennifer Harman. Ethical Standards apply to everyone, or they apply to no one. Standard 2.04 says what it says, and the “established scientific and professional knowledge of the discipline” is what it is.

We need to establish baseline standards for professional clinical practice in the family courts. By disregarding the mandatory requirements of the APA ethics code and spreading misinformation to the general public, other mental health professionals, and to the court, Amy Baker and Jennifer Harman are encouraging others to do the same. Either the APA ethics code applies to ALL psychologists, or it applies to NO psychologists.

It applies to all psychologists. Amy Baker and Jennifer Harman are not exempt from their mandatory ethical obligations under Standards 2.01 and 2.04 of the Ethical Standards of Psychologists and Code of Conduct of the American Psychological Association. The APA ethics code is mandatory – ethical practice is NOT optional

Google mandatory: required by law or rules; compulsory.

Google required: officially compulsory, or otherwise considered essential; indispensable.

Google indispensable: absolutely necessary.

Ethical practice by all psychologists is indispensable and absolutely necessary. Compliance with ethical Standards 2.01 and 2.04 is mandatory-required.

Unethical practice and the spread of psychiatric/psychological misinformation degrades the quality of clinical services and clinical care delivered to children and parents in the family courts. The children, their parents, and the Court, deserve the highest quality of professional services, not the lowest.

Compliance with the APA ethics code is mandatory – compulsory – essential and required – for all psychologists. Amy Baker and Jennifer Harman are not exempt from their professional ethical obligations to restrict their views to the boundaries of their competence (2.01), and to rely on the “established scientific and professional knowledge” as the bases for their scientific and professional judgments (2.04) – first – not after –  not instead of.

As a licensed clinical psychologist working directly with these children and parents in the family courts, I am instructing Amy Baker and Jennifer Harman to discontinue the use of “parental alienation” in a professional capacity because the use of that construct substantially degrades the quality of clinical services received by parents and children in the family courts.

Promoting the APA-rejected diagnostic construct of “parental alienation” through the Internet to the general public and to other other mental health professionals, represents a reckless and irresponsible spreading of psychiatric/psychological misinformation to the general public, causing substantial harm to the parents and children in the family courts, and it substantially degrades the quality of clinical services received by children, parents, and the Court.

Standards 1.04 & 1.05

I am required – mandated – by Standard 1.04 of the Ethical Principles of Psychologists and Code of Conduct of the American Psychological Association to bring apparent ethical violations to the “attention of that individual” seeing informal resolution.

I am doing that through this notification in an attempt at an informal resolution, because, as a licensed clinical psychologist working with parents and children in the family courts, I believe there may have been an ethical violation by another psychologist – Amy Baker and Jennifer Harman.

By their continuing irresponsible spreading of medical-psychiatric misinformation to the general public about a non-existent pathology, their disregard of their ethical obligations under Standard 2.01 and 2.04 is causing substantial harm to the parents and children in the family courts by degrading the quality of clinical services they seek and receive.

If the concerns for apparent the ethical violations to Standards 2.01 Boundaries of Competence and 2.04 Bases for Scientific and Professional Judgments are not properly resolved by bringing it to the attention of the individuals involved, then I am required (mandatory) under Standard 1.05 to “take further action appropriate to the situation” – with offered guidance from Standard 1.05 of making a “referral to state or national committees on professional ethics, to state licensing boards, or to the appropriate institutional authorities.”

Since neither Amy Baker nor Jennifer Harman are licensed clinical psychologists, no recourse to their licensing boards is available because they have none, leaving only the other recommended options for “further action appropriate to the situation” – i.e., referral to state or national committees on professional ethics, or to appropriate institutional authorities.

As a licensed clinical psychologists, for the well-being of the parents and children in the family courts who need an accurate diagnosis and effective treatment for the pathology in their families, I urge Amy Baker and Jennifer Harman to restrict themselves to the application of the established scientific and professional knowledge of the discipline FIRST – not after – not instead of – FIRST.

The appropriate clinical descriptions of the pathology to provide to parents, other mental health professionals, and the courts are the following:

Delusional thought disorders – cite to Walters & Friedlander (2016), cite to Childress (2015)..

Cross-generational coalitions and emotional cutoffs – cite to Minuchin and Bowen.

Personalty disorders – cite to Beck, Millon, Kernberg, Linehan, and Dark personality research.

Complex trauma and child abuse – cite to van der Kolk and Cicchetti.

Attachment – cite to Bowlby, Tronick, Lyons-Ruth, Sroufe.

If you are not competent in these domains of established scientific and professional knowledge, then I refer you to Standard 2.03 Maintaining Competence.

2.03 Maintaining Competence
Psychologists undertake ongoing efforts to develop and maintain their competence.

The continued spreading of psychiatric/psychological misinformation on the Internet must stop – it substantially degrades the quality of clinical services received by parents and children in the family courts, causing substantial harm to both the children and their parents.

There is a reason for ethical Standards of practice. There is a reason they are mandatory. Unethical practice hurts people – a lot. Like here.

We must establish a baseline of professional quality in the clinical services provided to these parents and children in the family courts. I urge Amy Baker and Jennifer Harman to more fully embrace their ethical obligations under Standards 2.01 and 2.04.

Craig Childress, Psy.D.
Licensed Clinical Psychologist, CA PSY 18857